MEDICARE: DR. SCOTT CENTERS MD

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	207P00000X	Emergency Medicine Physician	2007-00924	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1464J	OTHER	NC	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760511695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT CENTERS MD

Provider Business Mailing Address
First Line	:	1028 LEE ANN DR NE
Second Line	:
City	:	CONCORD
State	:	NC
Zip	:	28025-2903
Country	:	US
Telephone Number	:	704-782-1892
Fax Number	:

Provider Business Practice Location Address
First Line	:	1028 LEE ANN DR NE
Second Line	:	SUITE 200
City	:	CONCORD
State	:	NC
Zip	:	28025-2903
Country	:	US
Telephone Number	:	704-782-1892
Fax Number	:	704-786-1890

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

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	11/21/2013

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