Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 01050870A | IN |
NPI | 1386639565 |
---|---|
Provider Name | Scott C Boyd |
First Address | Carmel, IN 46032-3950 |
Second Address | Fort Wayne, IN 46825-1633 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2005 |
Last Update Date | 02/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200381080 | (05) | IN |