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Individual

KEVIN SCRUGGS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5601 LOCH RAVEN BLVD, BALTIMORE, MD 21239-2905
(443) 444-4820
(443) 444-5957
Mailing address
5601 LOCH RAVEN BLVD, BALTIMORE, MD 21239-2905
(443) 444-4820
(443) 444-5957

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
D38543
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
532011900
MD
01
60609101
BLUE CROSS
MD
01
P00214341
RAILROAD MEDICARE
MD
Enumeration date
06/01/2006
Last updated
04/02/2009
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