MEDICARE: TOBIN SCOTT NAIDORF 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	207R00000X	Internal Medicine Physician	0101043875	VA
2	207RG0100X	Gastroenterology Physician	0101043875	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457306318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TOBIN SCOTT NAIDORF MD

Provider Business Mailing Address
First Line	:	P.O. BOX 37174
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21297-3174
Country	:	US
Telephone Number	:	571-423-5699
Fax Number	:	571-423-5698

Provider Business Practice Location Address
First Line	:	2501 PARKERS LN SUITE 114
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22306-3410
Country	:	US
Telephone Number	:
Fax Number	:

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

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	08/09/2022

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