Provider Demographics
NPI:1104866227
Name:MONTEITH, SCOTT ARTHUR (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ARTHUR
Last Name:MONTEITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:526 W 14TH ST
Mailing Address - Street 2:SUITE 186
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-4051
Mailing Address - Country:US
Mailing Address - Phone:231-929-2550
Mailing Address - Fax:231-929-2550
Practice Address - Street 1:526 W 14TH ST
Practice Address - Street 2:SUITE 186
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-4051
Practice Address - Country:US
Practice Address - Phone:231-775-3463
Practice Address - Fax:231-929-2550
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI43010565092084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI7006570Medicaid
MI260-33-0631-2OtherBCBS
MI7006570Medicaid