MEDICARE: PEGGY JB SCURRY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	MD11706	DC

General Provider Information

NPI Number	:	1063525194
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PEGGY JB SCURRY MD

Provider Business Mailing Address
First Line	:	300 SPRINGBROOK DR
Second Line	:	SILVER SPRING
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-2835
Country	:	US
Telephone Number	:	301-622-7053
Fax Number	:	301-622-1850

Provider Business Practice Location Address
First Line	:	8484 GEORGIA AVE
Second Line	:	SILVER SPRING
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-5604
Country	:	US
Telephone Number	:	301-495-7420
Fax Number	:	301-495-7423

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2006
Last Update Date	:	07/08/2007

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