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General NPI Number Information
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NPI Number | 1144331398
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Entity Type | Individual
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Provider Name | CONSTANCE L SCOTT DO
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 01/16/2019
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Provider Practice Location Address
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Address Line | 6300 STATE STREET SUITE 2
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City | SAGINAW
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State | MI
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Zip | 48603
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Country | US
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Telephone | 989-797-7546
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Fax | 989-797-6007
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Provider Business Mailing Address
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Address Line | 3785 BAY RD
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City | SAGINAW
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State | MI
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Zip | 48603-2433
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Country | US
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Telephone | 989-791-2455
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Fax | 989-791-1392
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 5101012096
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License Number State | MI
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