Provider Demographics
NPI:1578598611
Name:MORSBERGER, SCOTT D (PA-C)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:D
Last Name:MORSBERGER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:193 STONER AVE
Mailing Address - Street 2:SUITE 340
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5587
Mailing Address - Country:US
Mailing Address - Phone:410-871-9800
Mailing Address - Fax:410-871-9801
Practice Address - Street 1:193 STONER AVE
Practice Address - Street 2:SUITE 340
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5587
Practice Address - Country:US
Practice Address - Phone:410-871-9800
Practice Address - Fax:410-871-9801
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0002273363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
000LF410Medicare ID - Type Unspecified
P21733Medicare UPIN