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Individual
DR. SCOTT EDWARD FANNIN
Active
Individual
DR. SCOTT EDWARD FANNIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
5101016126
MI
207Q00000X
Family Medicine Physician
Primary
OP00002196
WA
Other
Enumeration date
10/03/2006
Last updated
08/29/2007
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