Individual
JEREMY SCRANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1130 ANNAPOLIS RD, ODENTON, MD 21113-1648
(410) 672-2255
Mailing address
1130 ANNAPOLIS RD, ODENTON, MD 21113-1648
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
C0008179
MD
363AM0700X
Medical Physician Assistant
Primary
C08179
MD
Other
Enumeration date
10/05/2021
Last updated
08/19/2022
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