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General NPI Number Information
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NPI Number | 1659569143
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Entity Type | Organization
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Legal Business Name | SIMON V. SCALIA M.D. LLC
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 10/09/2007
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Provider Practice Location Address
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Address Line | 2801 HUDSON ST
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City | BALTIMORE
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State | MD
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Zip | 21224-4998
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Country | US
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Telephone | 410-342-4142
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Fax | 410-342-1920
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Provider Business Mailing Address
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Address Line | 10 OLD LYME RD
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City | LUTHERVILLE
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State | MD
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Zip | 21093-3760
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Country | US
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Telephone | 410-342-4142
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Fax | 410-342-1920
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. SIMON V SCALIA
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Credential | M.D.
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Telephone | 410-342-4142
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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