Individual
MARTY B SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
052235
GA
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
32427
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
063665382A
—
GA
01
—
10065388
AMERIGROUP
GA
01
—
349826
WELLCARE
GA
05
—
N32427
—
SC
Enumeration date
06/27/2006
Last updated
11/05/2010
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