Healthcare Provider Details

I. General information

NPI: 1447236435
Provider Name (Legal Business Name): SCOTT C MCGOVERN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2005
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1675 WOODBROOKE DR
SALISBURY MD
21804-8502
US

IV. Provider business mailing address

PO BOX 69709
BALTIMORE MD
21264-9709
US

V. Phone/Fax

Practice location:
  • Phone: 410-749-4154
  • Fax:
Mailing address:
  • Phone: 410-749-4154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberD0069182
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberD0069182
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA103855
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: