Individual
JOHN CHARLES SCANLON
Active
Individual
JOHN CHARLES SCANLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
01023751A
IN
207RP1001X
Pulmonary Disease Physician
01023751A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000191108
ANTHEM PROVIDER NUMBER
IN
05
—
100231140
—
IN
01
—
10825885
CAQH NUMBER
IN
01
—
9397438
PHCS PID NUMBER
IN
05
—
SC80461029
—
IN
Enumeration date
03/16/2006
Last updated
07/23/2012
Update your record
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