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General NPI Number Information
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NPI Number | 1700925088
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Entity Type | Organization
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Legal Business Name | DWIGHT E SCOTT DPM INC
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 05/10/2010
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Provider Practice Location Address
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Address Line | 6001 WOODLAND AVE SUITE 2345
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City | CLEVELAND
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State | OH
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Zip | 44104-2762
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Country | US
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Telephone | 216-426-9314
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Fax | 216-426-9314
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Provider Business Mailing Address
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Address Line | PO BOX 6212
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City | CLEVELAND
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State | OH
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Zip | 44101-1212
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | DR. DWIGHT EUGENE SCOTT
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Credential | DPM
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Telephone | 216-426-9314
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 36002551
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License Number State | OH
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