Healthcare Provider Details

I. General information

NPI: 1417234204
Provider Name (Legal Business Name): DORCHESTER COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2011
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

627 RACE ST
CAMBRIDGE MD
21613-2333
US

IV. Provider business mailing address

627 RACE ST
CAMBRIDGE MD
21613-2333
US

V. Phone/Fax

Practice location:
  • Phone: 410-228-3223
  • Fax: 410-228-9319
Mailing address:
  • Phone: 410-228-3223
  • Fax: 410-228-9319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CASEY R SCOTT
Title or Position: HEALTH OFFICER
Credential: MD
Phone: 410-228-3223