Healthcare Provider Details

I. General information

NPI: 1295750628
Provider Name (Legal Business Name): PENELOPE SCOTT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 08/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 LOCH RAVEN BLVD SUITE 512
BALTIMORE MD
21239
US

IV. Provider business mailing address

400 REDLAND COURT SUITE 208
OWINGS MILLS MD
21117-3292
US

V. Phone/Fax

Practice location:
  • Phone: 443-444-4835
  • Fax: 443-444-4894
Mailing address:
  • Phone: 410-494-7921
  • Fax: 410-902-8247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberD0015135
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberD15135
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: