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General NPI Number Information
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NPI Number | 1629386222
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Entity Type | Individual
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Provider Name | JOHN SCOTT GIVLER JR. PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/16/2010
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Last Update Date | 04/01/2019
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Provider Practice Location Address
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Address Line | 17 FONTANA LN STE 101
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City | BALTIMORE
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State | MD
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Zip | 21237-3017
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Country | US
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Telephone | 410-687-0000
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Fax | 410-391-8656
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Provider Business Mailing Address
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Address Line | 17 FONTANA LN 101
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City | BALTIMORE
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State | MD
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Zip | 21237-3017
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Country | US
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Telephone | 410-687-0000
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Fax | 410-391-8656
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C0004325
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | C0004325
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License Number State | MD
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