Provider Demographics
NPI:1710043732
Name:LEPRE, SCOTT JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:JOHN
Last Name:LEPRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:201 E. UNIVERSITY PKWY., SUITE 670
Mailing Address - Street 2:MEDSTAR UNION MEMORIAL HOSPITAL
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218
Mailing Address - Country:US
Mailing Address - Phone:410-554-6695
Mailing Address - Fax:
Practice Address - Street 1:201 E. UNIVERSITY PKWY., SUITE 670
Practice Address - Street 2:MEDSTAR UNION MEMORIAL HOSPITAL
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218
Practice Address - Country:US
Practice Address - Phone:410-554-6695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0067111208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD018190100Medicaid
MD126862YTLMedicare PIN