Basic Information
| Provider Information | |||||||||
| NPI: | 1295886802 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CLINE | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | DAVID | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1119 MILES AVE | ||||||||
| Address2: | |||||||||
| City: | KALAMAZOO | ||||||||
| State: | MI | ||||||||
| PostalCode: | 490014986 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2693492737 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1850 WHITES RD STE 3 | ||||||||
| Address2: | |||||||||
| City: | KALAMAZOO | ||||||||
| State: | MI | ||||||||
| PostalCode: | 490084801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2693433900 | ||||||||
| FaxNumber: | 2693435640 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/12/2007 | ||||||||
| LastUpdateDate: | 02/01/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 4301083469 | MI | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 49952 | MN | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.