Scott, Clinton Herwin

Scott, Clinton Herwin is an sole proprietor health care provider with primary practice located at 3903 Portage Rd Suite C # 161, South Bend IN 46628-4431. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Scott, Clinton Herwin can be contacted via phone (609) 440-8714.

Contact Information

Primary practice address
3903 Portage Rd Suite C # 161 South Bend IN 46628-4431
Phone: (609) 440-8714
Fax: (269) 469-9240
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 07000990A Indiana

Profile Details

NPI number 1750360137
LBN Legal business name Scott, Clinton Herwin
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 12th, 2006
Last updated Sep 30th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750360137 NPPES
Indiana Other 000000339432 ANTHEM
Indiana MEDICAID 200305000 ANTHEM

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