Individual
KEVIN C SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
325 E H ST, IRON MOUNTAIN, MI 49801-4760
(067) 774-3300
Mailing address
325 E H ST, IRON MOUNTAIN, MI 49801-4760
(906) 774-3300
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
4301085671
MI
208800000X
Urology Physician
Primary
4301085671
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34-0-22-1066-2
BLUE CROSS BLUE SHIELD
MI
05
—
4763830
—
MI
05
—
4940774
—
MI
Enumeration date
10/23/2006
Last updated
05/13/2020
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