Individual
MARCUS W SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
5 MATCHETT DR, PIERCETON, IN 46562-9073
(574) 594-2136
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10000439A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000767055
ANTHEM
IN
Enumeration date
09/02/2009
Last updated
10/20/2022
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