Provider Demographics
NPI:1316629991
Name:SCOTT, KALI ELIZABETH (DVM)
Entity type:Individual
Prefix:
First Name:KALI
Middle Name:ELIZABETH
Last Name:SCOTT
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 RIVERS EDGE DR UNIT 144
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-5463
Mailing Address - Country:US
Mailing Address - Phone:508-505-6956
Mailing Address - Fax:
Practice Address - Street 1:1415 MAIN ST
Practice Address - Street 2:
Practice Address - City:TEWKSBURY
Practice Address - State:MA
Practice Address - Zip Code:01876-2041
Practice Address - Country:US
Practice Address - Phone:978-851-5558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9546207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine