Provider Demographics
NPI:1770843781
Name:PILLA, SCOTT JORDAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:JORDAN
Last Name:PILLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9910 FRANKLIN SQUARE DR STE 2110
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4902
Mailing Address - Country:US
Mailing Address - Phone:410-933-6423
Mailing Address - Fax:
Practice Address - Street 1:5200 EASTERN AVENUE
Practice Address - Street 2:3RD FLOOR, ROOM 326 MASON LORD BUILDING
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224
Practice Address - Country:US
Practice Address - Phone:410-550-0530
Practice Address - Fax:410-550-0491
Is Sole Proprietor?:No
Enumeration Date:2012-05-23
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD78939207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine