Provider Demographics
NPI:1659413094
Name:RIDDELL, SCOTT VARNES (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:VARNES
Last Name:RIDDELL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12065 OLD MERIDIAN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-5376
Mailing Address - Country:US
Mailing Address - Phone:317-844-5351
Mailing Address - Fax:317-844-0310
Practice Address - Street 1:12065 OLD MERIDIAN ST STE 100
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032
Practice Address - Country:US
Practice Address - Phone:317-844-5351
Practice Address - Fax:317-844-0310
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2010-03-24
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Provider Licenses
StateLicense IDTaxonomies
IN01037635208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics