Healthcare Provider Details

I. General information

NPI: 1962339648
Provider Name (Legal Business Name): MARCELL DAVON SCOTT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3425 NEBRASKA AVE
TOLEDO OH
43607-2861
US

IV. Provider business mailing address

3244 JEANNETTE AVE
TOLEDO OH
43608-2151
US

V. Phone/Fax

Practice location:
  • Phone: 567-249-8546
  • Fax:
Mailing address:
  • Phone: 567-249-8546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: