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Individual

MICHAEL B SCOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1717 S CALHOUN ST, FORT WAYNE, IN 46802-5257
(260) 458-2641
(260) 969-2900
Mailing address
1717 S CALHOUN ST, FORT WAYNE, IN 46802-5257
(260) 458-2641
(260) 969-2900

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01031177A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100359750
IN
01
160050663
RAIL ROAD MEDICARE
IN
Enumeration date
10/25/2005
Last updated
05/11/2017
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