Provider Demographics
NPI:1407885650
Name:SCOTT C. ERWOOD, M.D., LLC
Entity Type:Organization
Organization Name:SCOTT C. ERWOOD, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:CLEMENTS
Authorized Official - Last Name:ERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-265-1044
Mailing Address - Street 1:285 BOULEVARD NE STE 140
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-4204
Mailing Address - Country:US
Mailing Address - Phone:404-265-1044
Mailing Address - Fax:404-265-1047
Practice Address - Street 1:285 BOULEVARD NE STE 140
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-4204
Practice Address - Country:US
Practice Address - Phone:404-265-1044
Practice Address - Fax:404-265-1047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA39783207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAE04922Medicare UPIN