Provider Demographics
NPI:1609176452
Name:SCOVILLE, KATHERINE JANE (DO)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:JANE
Last Name:SCOVILLE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:10325 LLOYD RD
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-1950
Mailing Address - Country:US
Mailing Address - Phone:301-304-3330
Mailing Address - Fax:301-304-3331
Practice Address - Street 1:10325 LLOYD RD
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-1950
Practice Address - Country:US
Practice Address - Phone:914-358-9559
Practice Address - Fax:914-358-9560
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-27
Last Update Date:2022-05-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY258780204D00000X
MDH0092676204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM