Individual
SCOTT S YEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2231 CAREW ST, FORT WAYNE, IN 46805-4713
(260) 373-7765
(260) 373-7760
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01084841A
IN
207R00000X
Internal Medicine Physician
036090452
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001634609
GROUP BC BS
IL
05
—
036090452
—
IL
01
—
P00145831
MEDICARE RAILROAD
IL
Enumeration date
05/03/2006
Last updated
03/09/2023
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