Healthcare Provider Details

I. General information

NPI: 1063525194
Provider Name (Legal Business Name): PEGGY JB SCURRY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8484 GEORGIA AVE SILVER SPRING
SILVER SPRING MD
20910-5604
US

IV. Provider business mailing address

300 SPRINGBROOK DR SILVER SPRING
SILVER SPRING MD
20904-2835
US

V. Phone/Fax

Practice location:
  • Phone: 301-495-7420
  • Fax: 301-495-7423
Mailing address:
  • Phone: 301-622-7053
  • Fax: 301-622-1850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD11706
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: