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NPI Code Detail

MEDICARE: DR. SCOTT W NEBEL O.D.

MEDICARE: DR. SCOTT W NEBEL O.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
1152W00000XOptometrist2185NC

General Provider Information

NPI Number : 1669602207
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SCOTT W NEBEL O.D.
Provider Business Mailing Address
First Line : 1703 LUTHER ST
Second Line :
City : CHARLOTTE
State : NC
Zip : 28204-3139
Country : US
Telephone Number : 724-494-5480
Fax Number :
Provider Business Practice Location Address
First Line : 169 NORMAN STATION BLVD
Second Line :
City : MOORESVILLE
State : NC
Zip : 28117-6396
Country : US
Telephone Number : 704-663-3796
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2009
Last Update Date : 02/19/2021

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