DR. SCOTT JACOB FUDEMBERG (NPI# 1568510675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568510675 |
| Entity Type | Individual |
| Full Name | DR. SCOTT JACOB FUDEMBERG |
| Credential | M.D. |
| Practice Address |
30 Medical Center Blvd Ste 104 Chester PA 19013-3955 |
| Practice Telephone | 6108745261 |
| Practice Fax Number | 6108740318 |
| Mailing Telephone | 6108745261 |
| Mailing Fax Number | 6108740318 |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2020-11-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207W00000X | Ophthalmology | 25MA08470400 | NJ | Allopathic & Osteopathic Physicians |
| N | 207W00000X | Ophthalmology | C1-0008886 | DE | Allopathic & Osteopathic Physicians |
| Y | 207W00000X | Ophthalmology | MD431150 | PA | Allopathic & Osteopathic Physicians |
| N | 207W00000X | Ophthalmology | 6253 | KS | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 840 Walnut St Ste 1110, Philadelphia, PA 191075109 | 2159283197 | 2159280166 |
| Street Address |
30 MEDICAL CENTER BLVD STE 104 |
| City | CHESTER |
| State | PA |
| Zip Code | 19013-3955 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821080532 | Sheldon Lewis Morris | Ophthalmology | 30 Medical Center Blvd Ste 104, Chester, PA 19013-3955 | 2005-08-18 |
| 1205123866 | Matthew Patrick Mcguigan | Optometrist | 30 Medical Center Blvd Ste 104, Chester, PA 19013-3955 | 2011-07-05 |
| 1659583862 | Ophthalmic Surgical Associates | Ophthalmology | 30 Medical Center Blvd Ste 104, Chester, PA 19013-3955 | 2007-05-03 |
| 1568592665 | Deepika Bagga | Optometrist | 30 Medical Center Blvd Ste 104, Chester, PA 19013-3955 | 2007-03-07 |
| 1619921327 | Ophthalmic Surgical Associates Inc | Optometrist | 30 Medical Center Blvd Ste 104, Chester, PA 19013-3955 | 2006-05-19 |
| 1598739567 | Megan Buliano Smith | Optometrist | 30 Medical Center Blvd Ste 104, Chester, PA 19013-3955 | 2006-02-15 |
| 1225001845 | Christopher Alan Williams | Ophthalmology | 30 Medical Center Blvd Ste 104, Chester, PA 19013-3955 | 2006-02-13 |
| 1811984206 | John C Witherell | Ophthalmology | 30 Medical Center Blvd Ste 104, Chester, PA 19013-3955 | 2005-09-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790305043 | Erika Pack | Student in an Organized Health Care Education/Training Program | Crozer-chester Medical Center, 1 Medical Center Blvd., Upland, PA 19013 | 2020-04-16 |
| 1477195287 | Andrew Matthews | Counselor | 301 West 15 Street, Chester, PA 19013 | 2019-10-14 |
| 1780241133 | Raashidah Elizabeth Bowman | Contractor | 1208 Remington Street, Chester, PA 19013 | 2019-05-21 |
| 1134609464 | Shamira Clintonia Johnson | Nurse's Aide | 217 W 5th St, Chester, PA 19013 | 2018-08-16 |
| 1871081299 | Michael Briskey | Student in an Organized Health Care Education/Training Program | 1 Medical Center Blv.d, Chester, PA 19013 | 2018-05-01 |
| 1356845499 | Sonia Gaur | Internal Medicine | 1 Medical Center Blvd Fl 3, Chester, PA 19013 | 2018-03-22 |
| 1548619232 | Beth Barol | Social Worker | 1602 Walnut St, Center for Social Work Education, Chester, PA 19013 | 2016-06-03 |
| 1235594888 | Eryka Jackson | Counselor | 516 West 5th Street, Chester, PA 19013 | 2015-12-28 |
| 1437553146 | Erin Hipple | Counselor | 200 West 9th St, Chester, PA 19013 | 2014-10-09 |
| 1588079867 | Crozer Chester Medical Center | Clinic/Center | 201 Bridgewater Road, Chester Township, PA 19013 | 2014-06-25 |
| Find all providers in zip 19013 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003185836 | Kenneth Meyer | Ophthalmology | 125 Goose Bay View Trl, Chester, CA 96020-9737 | 2011-12-23 |
| 1508910803 | Vincent Joseph Hoye IIi | Ophthalmology | 385 State Route 24 Ste 2c, Chester, NJ 07930-2909 | 2007-01-23 |
| 1821080532 | Sheldon Lewis Morris | Ophthalmology | 30 Medical Center Blvd Ste 104, Chester, PA 19013-3955 | 2005-08-18 |
| 1972940195 | Melissa Tripoli | Ophthalmology | 1 Medical Center Blvd, Department of Medicine 3 East, Chester, PA 19013-3902 | 2013-05-29 |
| 1104025584 | Alexander Douglas Marion | Ophthalmology | 1 Medical Park Dr, Suite 1 A, Chester, SC 29706-9769 | 2007-07-16 |
| 1659583862 | Ophthalmic Surgical Associates | Ophthalmology | 30 Medical Center Blvd Ste 104, Chester, PA 19013-3955 | 2007-05-03 |
| 1811020506 | Hoye Eye Care, P.a. | Ophthalmology | 385 State Route 24 Ste 2c, Chester, NJ 07930-2909 | 2007-03-13 |
| 1225001845 | Christopher Alan Williams | Ophthalmology | 30 Medical Center Blvd Ste 104, Chester, PA 19013-3955 | 2006-02-13 |
| 1861463796 | Eye Associates of Chester Pa | Ophthalmology | 1 Medical Park Dr, Ste 1a, Chester, SC 29706-9769 | 2006-01-30 |
| 1811984206 | John C Witherell | Ophthalmology | 30 Medical Center Blvd Ste 104, Chester, PA 19013-3955 | 2005-09-30 |
| Find all providers in CHESTER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.