Provider Demographics
NPI:1285672568
Name:SCATTERGOOD, SUZANNE N (MD)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:N
Last Name:SCATTERGOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 RESEARCH BLVD.
Mailing Address - Street 2:STE. 350
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3180
Mailing Address - Country:US
Mailing Address - Phone:301-838-9606
Mailing Address - Fax:301-838-9029
Practice Address - Street 1:1901 RESEARCH BLVD.
Practice Address - Street 2:350
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3180
Practice Address - Country:US
Practice Address - Phone:301-838-9606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD30143207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD429471800Medicaid
601285800OtherFECA
MD015645F85Medicare ID - Type Unspecified
B67053Medicare UPIN
MD839MK227Medicare ID - Type Unspecified