Provider Demographics
NPI:1811108178
Name:MARTIN, SCOTT F (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:F
Last Name:MARTIN
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 1:2460 FAIRMOUNT BLVD STE 302
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44106-3164
Mailing Address - Country:US
Mailing Address - Phone:216-471-8066
Mailing Address - Fax:
Practice Address - Street 1:23230 CHAGRIN BLVD
Practice Address - Street 2:SUITE 350
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5446
Practice Address - Country:US
Practice Address - Phone:216-831-2900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.0121682084P0800X
OH35.0961372084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry