Provider Demographics
NPI:1275505711
Name:SCIPIO, LAURENCE H (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURENCE
Middle Name:H
Last Name:SCIPIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 ARMORY PL
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-4603
Mailing Address - Country:US
Mailing Address - Phone:410-225-8215
Mailing Address - Fax:410-225-8471
Practice Address - Street 1:300 ARMORY PL
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-4603
Practice Address - Country:US
Practice Address - Phone:410-225-8215
Practice Address - Fax:410-225-8471
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0022632174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDB73552Medicare UPIN