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Organization
MERCER ISLAND FAMILY MEDICINE, PLLC
Active
Organization
MERCER ISLAND FAMILY MEDICINE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT EDWARD FANNIN D.O. (PRESIDENT)
(586) 850-4645
Entity
Organization
Contact information
Practice address
3003 ISLAND CREST WAY, MERCER ISLAND, WA 98040-2998
(586) 850-4645
Mailing address
54196 KATHERINE WOOD DR, MACOMB, MI 48042-2315
(586) 850-4645
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OP00002196
WA
Other
Enumeration date
06/11/2007
Last updated
08/22/2020
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