Provider Demographics
NPI:1891778965
Name:IRRGANG, SCOTT T (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:T
Last Name:IRRGANG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9601 PULASKI PARK DR STE 417
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-1409
Mailing Address - Country:US
Mailing Address - Phone:410-933-5678
Mailing Address - Fax:410-933-4835
Practice Address - Street 1:125 E HIGH ST
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5624
Practice Address - Country:US
Practice Address - Phone:410-392-0300
Practice Address - Fax:410-392-5451
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01425111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1534410OtherCAQH
MD426279OtherCAREFIRST
MD426279OtherCAREFIRST
MDU01038Medicare UPIN