Provider Demographics
NPI:1215151568
Name:NEMEC, SCOTT ALLEN (DO)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:ALLEN
Last Name:NEMEC
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4048 CEDAR BLUFF DR
Mailing Address - Street 2:STE 1 PO BOX 430
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770
Mailing Address - Country:US
Mailing Address - Phone:231-347-5155
Mailing Address - Fax:231-347-6128
Practice Address - Street 1:4048 CEDAR BLUFF DR
Practice Address - Street 2:STE 1
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770
Practice Address - Country:US
Practice Address - Phone:231-347-5155
Practice Address - Fax:231-347-6128
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2009-08-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101015684207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI1871001Medicare PIN