Individual
DR. SCOTT R. BACKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6111 EXECUTIVE BLVD, ROCKVILLE, MD 20852-3911
(301) 255-4000
Mailing address
6111 EXECUTIVE BLVD, ROCKVILLE, MD 20852-3911
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
0101247623
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780864678
—
VA
05
—
PENDING
—
NC
Enumeration date
11/07/2007
Last updated
06/14/2021
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