Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 15897 | SC |
Y | 207Q00000X | Family Doctor | 15897 | SC |
NPI | 1003888769 |
---|---|
Provider Name | Dr. Michele A Scott |
First Address | Florence, SC 29501-2808 |
Second Address | Florence, SC 29501-2808 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2006 |
Last Update Date | 21/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
158974 | (05) | SC |
E81384 | (02) |