Healthcare Provider Details

I. General information

NPI: 1699720110
Provider Name (Legal Business Name): SCOTT CAMPBELL MORAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10770 COLUMBIA PIKE STE 3001301
SILVER SPRING MD
20901-4402
US

IV. Provider business mailing address

10770 COLUMBIA PIKE STE 3001301
SILVER SPRING MD
20901-4402
US

V. Phone/Fax

Practice location:
  • Phone: 301-453-8679
  • Fax: 301-381-8856
Mailing address:
  • Phone: 301-453-8679
  • Fax: 301-381-8856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberD84252
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD84252
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: