Healthcare Provider Details

I. General information

NPI: 1891561890
Provider Name (Legal Business Name): CARSON GREY SCHARF PT, DPT,
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2023
Last Update Date: 11/30/2023
Certification Date: 11/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9030 OLD ANNAPOLIS RD STE B
COLUMBIA MD
21045-1990
US

IV. Provider business mailing address

1004 KINGSBRIDGE TER
MOUNT AIRY MD
21771-5792
US

V. Phone/Fax

Practice location:
  • Phone: 443-979-8535
  • Fax:
Mailing address:
  • Phone: 301-788-5725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number29733
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: