Provider Demographics
NPI:1902010465
Name:KALINOWSKI, SCOTT ERIC (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:ERIC
Last Name:KALINOWSKI
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 1:25 CROSSROADS DR STE 306
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5437
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1313 E OSBORN RD STE 150
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-5688
Practice Address - Country:US
Practice Address - Phone:602-222-1900
Practice Address - Fax:602-266-3870
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ41355208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ399838Medicaid
AZ1902010465OtherNPI
AZ1902010465OtherNPI