Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 12928736 | OR |
N | 208600000X | Surgeon | 12928736 | OR |
N | 2082S0105X | Plastic Hand Surgeon | 12928736 | OR |
Y | 2082S0105X | Plastic Hand Surgeon | MD15288 | HI |
NPI | 1861559478 |
---|---|
Provider Name | Dr. Scott C. Young |
First Address | Kihei, HI 96753-9227 |
Second Address | Kihei, HI 96753-8145 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2007 |
Last Update Date | 11/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
055793 | (05) | OR |
F54250 | (02) | OR |