Provider Demographics
NPI:1639796428
Name:SCHOLAR MEDICAL GROUP MD LLC
Entity Type:Organization
Organization Name:SCHOLAR MEDICAL GROUP MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:DIPAK
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-935-1033
Mailing Address - Street 1:133 ROLLINS AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4040
Mailing Address - Country:US
Mailing Address - Phone:202-935-1033
Mailing Address - Fax:
Practice Address - Street 1:133 ROLLINS AVE STE 3
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4040
Practice Address - Country:US
Practice Address - Phone:202-935-1033
Practice Address - Fax:202-935-1033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-29
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center