MEDICARE: SCOTT G MARSTELLER 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	207Q00000X	Family Medicine Physician	01068656A	IN

General Provider Information

NPI Number	:	1891714937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT G MARSTELLER MD

Provider Business Mailing Address
First Line	:	1100 REID PKWY
Second Line	:
City	:	RICHMOND
State	:	IN
Zip	:	47374-1157
Country	:	US
Telephone Number	:	765-647-4231
Fax Number	:	765-547-1414

Provider Business Practice Location Address
First Line	:	617 MAIN ST STE A
Second Line	:
City	:	BROOKVILLE
State	:	IN
Zip	:	47012-1281
Country	:	US
Telephone Number	:	765-647-4231
Fax Number	:	765-547-1414

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

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	04/22/2020

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Directions to “ SCOTT G MARSTELLER MD” Practice Location

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