Individual
SCOTT E. MATTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
7411 HOPE DR STE C, FORT WAYNE, IN 46815-5687
(260) 234-5400
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
02001461A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000087427
ANTHEM
IN
01
—
060057216
RAILROAD
—
05
—
200207560
—
IN
05
—
2123446
—
OH
01
—
P00752848
RAILROAD
IN
Enumeration date
01/23/2006
Last updated
06/02/2022
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