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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