MEDICARE: DR. SCOTT ALAN SPENCER D.P.M.

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	36-00-2444-S	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CI 5538	OTHER	OH	RR MEDICARE GROUP BFAC
3	480017770	OTHER	OH	RR MEDICARE BFAC
4	CH 5179	OTHER	OH	RR MEDICARE GROUP CFAC
5	480031326	OTHER	OH	RAIL ROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1770589004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT ALAN SPENCER D.P.M.

Provider Business Mailing Address
First Line	:	6000 ROCKSIDE WOODS BLVD
Second Line	:
City	:	INDEPENDENCE
State	:	OH
Zip	:	44131-2330
Country	:	US
Telephone Number	:	216-231-3300
Fax Number	:

Provider Business Practice Location Address
First Line	:	7000 EUCLID AVE
Second Line	:	SUITE 101
City	:	CLEVELAND
State	:	OH
Zip	:	44103-4014
Country	:	US
Telephone Number	:	216-231-5612
Fax Number	:

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

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	02/28/2013

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Directions to “ DR. SCOTT ALAN SPENCER D.P.M.” Practice Location

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