MEDICARE: DR. MICHANGELO DARREN SCRUGGS DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	PO1000031	DC
2	213E00000X	Podiatrist	PO1000031	DC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	947AMD- MD	OTHER	DC	CAREFIRST BC/BS
2	J892	OTHER	DC	CAREFRIST BC/BS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104033703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHANGELO DARREN SCRUGGS DPM

Provider Business Mailing Address
First Line	:	4316 18TH ST NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20011-4228
Country	:	US
Telephone Number	:	202-412-9664
Fax Number	:

Provider Business Practice Location Address
First Line	:	1328 SOUTHERN AVE SE
Second Line	:	SUITE 209
City	:	WASHINGTON
State	:	DC
Zip	:	20032-4689
Country	:	US
Telephone Number	:	202-506-1001
Fax Number	:	202-506-1008

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

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	05/03/2010

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Directions to “ DR. MICHANGELO DARREN SCRUGGS DPM” Practice Location

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