Provider Demographics
NPI:1598725442
Name:WORRELL, SCOTT P (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:P
Last Name:WORRELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:11110 MEDICAL CAMPUS ROAD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742
Mailing Address - Country:US
Mailing Address - Phone:301-665-4950
Mailing Address - Fax:301-665-4956
Practice Address - Street 1:11110 MEDICAL CAMPUS ROAD
Practice Address - Street 2:SUITE 205
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742
Practice Address - Country:US
Practice Address - Phone:301-665-4950
Practice Address - Fax:301-665-4956
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0050634207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG07525Medicare UPIN
MD6987970015Medicare NSC
MD0449950002Medicare NSC
MD0449950001Medicare NSC