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NPI Code Detail

MEDICARE: DR. EDWARD DEMOND SCOTT M.D.

MEDICARE: DR. EDWARD DEMOND SCOTT M.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
1207Q00000XFamily Medicine Physician35-085181OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
24156762OTHEROHMEDICARE ID

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548259971
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDWARD DEMOND SCOTT M.D.
Provider Business Mailing Address
First Line : PO BOX 933132
Second Line :
City : CLEVELAND
State : OH
Zip : 44193-0001
Country : US
Telephone Number : 330-673-1016
Fax Number :
Provider Business Practice Location Address
First Line : 143 GOUGLER AVE
Second Line :
City : KENT
State : OH
Zip : 44240-2401
Country : US
Telephone Number : 330-673-1016
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2005
Last Update Date : 05/29/2019

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