Provider Demographics
NPI:1477530780
Name:SCOTT, CHERYL L'TANYA (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:L'TANYA
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:674 WATERFORD RD NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-7147
Mailing Address - Country:US
Mailing Address - Phone:404-630-9635
Mailing Address - Fax:
Practice Address - Street 1:BUILDING 1, COAST GUARD ISLAND
Practice Address - Street 2:COAST GUARD INTEGRATED SUPPORT COMMAND
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-5100
Practice Address - Country:US
Practice Address - Phone:510-437-3598
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174025207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine