Provider Demographics
NPI:1811993561
Name:GREER, SCOTT DOUGLAS (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:DOUGLAS
Last Name:GREER
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 1:6280 JACKSON DR
Mailing Address - Street 2:STE 8
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92119-3436
Mailing Address - Country:US
Mailing Address - Phone:619-464-1608
Mailing Address - Fax:619-461-8738
Practice Address - Street 1:6280 JACKSON DR
Practice Address - Street 2:STE 8
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92119-3436
Practice Address - Country:US
Practice Address - Phone:619-464-1608
Practice Address - Fax:619-461-8738
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG45633174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist