MEDICARE: DR. SCOTT EDWARD FANNIN D.O.

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	207Q00000X	Family Medicine Physician	5101016126	MI
2	207Q00000X	Family Medicine Physician	OP00002196	WA

General Provider Information

NPI Number	:	1467547760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT EDWARD FANNIN D.O.

Provider Business Mailing Address
First Line	:	3003 ISLAND CREST WAY
Second Line	:
City	:	MERCER ISLAND
State	:	WA
Zip	:	98040-2998
Country	:	US
Telephone Number	:	206-275-3487
Fax Number	:	206-275-3486

Provider Business Practice Location Address
First Line	:	3003 ISLAND CREST WAY
Second Line	:
City	:	MERCER ISLAND
State	:	WA
Zip	:	98040-2998
Country	:	US
Telephone Number	:	206-275-3487
Fax Number	:	206-275-3486

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	08/29/2007

Similar Medicare Providers

1114142841 — NADEEM MERCHANT DMD
Practice Location Address:

3003 ISLAND CREST WAY , SUITE #2
MERCER ISLAND, WA
98040-2998

Practice Phone: 206-232-6200
Practice Fax:

1194928697 — MERCER ISLAND FAMILY MEDICINE, PLLC
Practice Location Address:

3003 ISLAND CREST WAY
MERCER ISLAND, WA
98040-2998

Practice Phone: 586-850-4645
Practice Fax:

1386842722 — NADEEM MERCHANT DMD, PS
Practice Location Address:

3003 ISLAND CREST WAY , SUITE 2
MERCER ISLAND, WA
98040-2998

Practice Phone: 206-232-6200
Practice Fax: 206-232-6428

1598326407 — DR. SHAMS UL ISLAM DMD
Practice Location Address:

2802 RHODE ISLAND AVE NE
WASHINGTON, DC
20018-2998

Practice Phone: 202-269-3387
Practice Fax:

1588405393 — GRACE MINDCARE PC
Practice Location Address:

9311 SE 36TH ST STE 120
MERCER ISLAND, WA
98040-3741

Practice Phone: 206-312-5373
Practice Fax: 206-791-3968

1598549073 — KATHERINE AVIVA WYNN LSWAIC
Practice Location Address:

8015 SE 28TH STREET
MERCER ISLAND, WA
98040

Practice Phone: 206-236-1294
Practice Fax:

Directions to “ DR. SCOTT EDWARD FANNIN D.O.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.