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General NPI Number Information
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NPI Number | 1932274412
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Entity Type | Organization
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Legal Business Name | SHIRLEY B SCOTT MD PC
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 07/29/2010
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Provider Practice Location Address
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Address Line | 428 LUISA PLACE
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City | SANTA FE
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State | NM
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Zip | 87505
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Country | US
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Telephone | 505-986-9960
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Fax | 505-988-1550
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Provider Business Mailing Address
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Address Line | PO BOX 2670
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City | SANTA FE
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State | NM
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Zip | 87504
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Country | US
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Telephone | 505-986-9960
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Fax | 505-988-1550
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHIRLEY B SCOTT
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Credential | MD
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Telephone | 505-986-9960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | A034359
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | NM8995
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License Number State | NM
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