Provider Demographics
NPI:1285649756
Name:NINE, JEFFREY SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:SCOTT
Last Name:NINE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:GUAM OFFICE OF THE CHIEF MEDICAL EXAMINER
Mailing Address - Street 2:325 DUENAS DRIVE
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96913
Mailing Address - Country:US
Mailing Address - Phone:671-646-9363
Mailing Address - Fax:671-646-8860
Practice Address - Street 1:GUAM OFFICE OF THE CHIEF MEDICAL EXAMINER
Practice Address - Street 2:325 DUENAS DRIVE
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913
Practice Address - Country:US
Practice Address - Phone:671-646-9363
Practice Address - Fax:671-646-8860
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ28464207ZF0201X, 207ZP0102X
PAMD051862L207ZF0201X, 207ZP0102X
GUM-2299207ZP0102X, 207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology