1437338290 NPI number — DAVID A. SCOTT, BC-HIS BC-HIS

Table of content: DAVID A. SCOTT, BC-HIS BC-HIS (NPI 1437338290)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437338290 NPI number — DAVID A. SCOTT, BC-HIS BC-HIS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCOTT, BC-HIS
Provider First Name:
DAVID
Provider Middle Name:
A.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
BC-HIS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437338290
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/12/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6950 W 130TH ST
Provider Second Line Business Mailing Address:
MIRACLE EAR HEARING CENTER
Provider Business Mailing Address City Name:
CLEVELAND
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44130-7809
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
440-842-3047
Provider Business Mailing Address Fax Number:
440-842-0451

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6950 W 130TH ST
Provider Second Line Business Practice Location Address:
MIRACLE EAR HEARING CENTER
Provider Business Practice Location Address City Name:
CLEVELAND
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44130-7809
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
440-842-3047
Provider Business Practice Location Address Fax Number:
440-842-0451
Provider Enumeration Date:
10/29/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 237700000X , with the licence number:  2822 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: NBC-HIS 6838 . This is a "NATIONAL BOARD FOR CERTIFICATION IN HEARING INSTRUMENT SCIENCES" identifier . This identifiers is of the category "OTHER".




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