Individual
DR. CLINTON HERWIN SCOTT JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
3903 PORTAGE RD, SUITE C # 161, SOUTH BEND, IN 46628-4431
(609) 440-8714
(269) 469-9240
Mailing address
3903 PORTAGE RD, SUITE C #161, SOUTH BEND, IN 46628-4431
(609) 440-8714
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
07000990A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000339432
ANTHEM
IN
05
—
200305000
—
IN
Enumeration date
01/12/2006
Last updated
09/30/2010
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