Healthcare Provider Details

I. General information

NPI: 1760581565
Provider Name (Legal Business Name): DR. SCOTT M CROLL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 07/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WRAMC, BLD 2 WD 44 ANESTHESIA 6900 GEORGIA AVE
WASHINGTON DC
20307
US

IV. Provider business mailing address

8000 E MAPLEWOOD AVE STE 200
GREENWOOD VILLAGE CO
80111-4727
US

V. Phone/Fax

Practice location:
  • Phone: 202-782-0039
  • Fax:
Mailing address:
  • Phone: 303-783-4908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0101222137
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: