Provider Demographics
NPI:1558327650
Name:SCOTT, CHARLES BREWSTER (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:BREWSTER
Last Name:SCOTT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 52ND ST
Mailing Address - Street 2:NEONATOLOGY 3RD FLOOR
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-1809
Mailing Address - Country:US
Mailing Address - Phone:510-428-3276
Mailing Address - Fax:510-450-5823
Practice Address - Street 1:747 52ND ST
Practice Address - Street 2:NEONATOLOGY 3RD FLOOR
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-1809
Practice Address - Country:US
Practice Address - Phone:510-428-3276
Practice Address - Fax:510-450-5823
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG35088174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist