MEDICARE: SCOTT DANIEL MCGRATH AU.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DA11567	OTHER	AZ	STATE LICENSE NUMBER

General Provider Information

NPI Number	:	1013480722
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT DANIEL MCGRATH AU.D.

Provider Business Mailing Address
First Line	:	2501 E SOUTHERN AVE STE 20
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-7667
Country	:	US
Telephone Number	:	480-833-4330
Fax Number	:	480-833-1902

Provider Business Practice Location Address
First Line	:	2501 E SOUTHERN AVE STE 20
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-7667
Country	:	US
Telephone Number	:	480-833-4330
Fax Number	:	480-833-1902

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2019
Last Update Date	:	02/04/2019

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