Provider Demographics
NPI:1437338290
Name:SCOTT, BC-HIS, DAVID A (BC-HIS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:SCOTT, BC-HIS
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6950 W 130TH ST
Mailing Address - Street 2:MIRACLE EAR HEARING CENTER
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44130-7809
Mailing Address - Country:US
Mailing Address - Phone:440-842-3047
Mailing Address - Fax:440-842-0451
Practice Address - Street 1:6950 W 130TH ST
Practice Address - Street 2:MIRACLE EAR HEARING CENTER
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-7809
Practice Address - Country:US
Practice Address - Phone:440-842-3047
Practice Address - Fax:440-842-0451
Is Sole Proprietor?:No
Enumeration Date:2007-10-29
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2822237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NBC-HIS 6838OtherNATIONAL BOARD FOR CERTIFICATION IN HEARING INSTRUMENT SCIENCES