Provider Demographics
NPI:1750353934
Name:GARNER, SCOTT A (MD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:A
Last Name:GARNER
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 1:5020 W BRISTOL RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-2919
Mailing Address - Country:US
Mailing Address - Phone:810-732-1620
Mailing Address - Fax:810-732-8559
Practice Address - Street 1:5020 W BRISTOL RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-2919
Practice Address - Country:US
Practice Address - Phone:810-732-1620
Practice Address - Fax:810-732-8559
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISG0612162086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2950691Medicaid
MI382237803113OtherCOMMUNITY CHOICE
MIE04926OtherHEALTH ALLIANCE PLAN
MI0202525662OtherBC/BS OF MICHIGAN
MI105380OtherPREFERRED CHOICE PPO
MI204108OtherMCLAREN HEALTH PLAN/ADVAN
MI105380OtherCARE CHOICE HMO
MI108138OtherGREAT LAKES HEALTH PLAN
MI5145173OtherAETNA
MIC4321OtherM-CARE
MI0202525662OtherHEALTHPLUS OF MICHIGAN
MI0202525662OtherBC/BS OF MICHIGAN
MI105380OtherPREFERRED CHOICE PPO