MEDICARE: DR. EDWARD G SCATES DPM

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	213E00000X	Podiatrist	DPM326	AZ

General Provider Information

NPI Number	:	1487640710
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD G SCATES DPM

Provider Business Mailing Address
First Line	:	3832 E THOMAS RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-7510
Country	:	US
Telephone Number	:	602-955-4515
Fax Number	:	602-955-7096

Provider Business Practice Location Address
First Line	:	3832 E THOMAS RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-7510
Country	:	US
Telephone Number	:	602-955-4515
Fax Number	:	602-955-7096

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

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	07/08/2007

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