Individual
SCOTT M BOUTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11000 EUCLID AVE, CLEVELAND, OH 44106-1714
(440) 684-5829
(440) 449-1555
Mailing address
3605 WARRENSVILLE CENTER RD, SHAKER HTS, OH 44122-5203
(440) 684-5829
(440) 449-1555
Taxonomy
Speciality
Code
Description
License number
State
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
35-084734
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221061
UNISON
OH
01
—
000000337118
ANTHEM
OH
01
—
1011138340001
PA MEDICAID
PA
01
—
2502410
BCMH
OH
05
—
2502410
—
OH
01
—
363374
WELLCARE
OH
01
—
7288591
AETNA
OH
01
—
732324
BUCKEYE
OH
01
—
P00412306
RAILROAD MEDICARE
OH
Enumeration date
01/05/2007
Last updated
05/20/2008
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