Individual
DR. SCOTT DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5050 N CLINTON ST, FORT WAYNE, IN 46825-5886
(260) 484-8551
(260) 482-5060
Mailing address
5052 N CLINTON ST, FORT WAYNE, IN 46825-5822
(260) 484-8551
(260) 482-5060
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01040348A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000082096
ANTHEM BC/BS
IN
05
—
200176780A
—
IN
01
—
9044
PHP
IN
Enumeration date
07/11/2005
Last updated
10/22/2018
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