MEDICARE: DANIELLE SCOGLAND PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	20626	MD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	283MK079	OTHER	MD	MEDICARE PTAN

General Provider Information

NPI Number	:	1205864311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE SCOGLAND PT

Provider Business Mailing Address
First Line	:	18109 PRINCE PHILIP DR STE 155
Second Line	:
City	:	OLNEY
State	:	MD
Zip	:	20832-1591
Country	:	US
Telephone Number	:	301-260-3280
Fax Number	:

Provider Business Practice Location Address
First Line	:	7310 RITCHIE HWY
Second Line	:	SUITE 500
City	:	GLEN BURNIE
State	:	MD
Zip	:	21061-3065
Country	:	US
Telephone Number	:	410-766-4047
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	12/17/2019

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Directions to “ DANIELLE SCOGLAND PT” Practice Location

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