Provider Demographics
NPI:1699786046
Name:SCOTT, BYRON CHRISTOPHER (MD)
Entity type:Individual
Prefix:DR
First Name:BYRON
Middle Name:CHRISTOPHER
Last Name:SCOTT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 HOOLAPA ST
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-6295
Mailing Address - Country:US
Mailing Address - Phone:808-757-6819
Mailing Address - Fax:
Practice Address - Street 1:121 HOOLAPA ST
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-6295
Practice Address - Country:US
Practice Address - Phone:808-757-6819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036136573207P00000X
HIMD-17238207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F23672Medicare UPIN