Provider Demographics
NPI:1922340033
Name:SISKIND, SCOTT ALEXANDER (MBBCHBAO)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ALEXANDER
Last Name:SISKIND
Suffix:
Gender:M
Credentials:MBBCHBAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 HOGBACK RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9750
Mailing Address - Country:US
Mailing Address - Phone:734-786-2300
Mailing Address - Fax:734-786-4915
Practice Address - Street 1:2006 HOGBACK RD
Practice Address - Street 2:SUITE 1
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-9750
Practice Address - Country:US
Practice Address - Phone:734-786-2300
Practice Address - Fax:734-786-4915
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-27
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1474712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry