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General NPI Number Information
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NPI Number | 1710289632
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Entity Type | Organization
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Legal Business Name | CHARLES F SCOTT MD PC
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Dates
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Enumeration Date | 11/29/2010
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Last Update Date | 11/29/2010
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Provider Practice Location Address
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Address Line | 2812 SPRING RD SE SUITE 200
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City | ATLANTA
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State | GA
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Zip | 30339-3037
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Country | US
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Telephone | 770-431-8511
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Fax | 770-431-8411
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Provider Business Mailing Address
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Address Line | 4279 ROSWELL RD SUITE 254
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City | ATLANTA
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State | GA
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Zip | 30342-3769
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Country | US
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Telephone | 770-431-8511
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Fax | 770-431-8411
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | CHARLES FREDERICK SCOTT
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Credential | MD
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Telephone | 770-431-8511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 02884
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License Number State | GA
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