Provider Demographics
NPI:1134398886
Name:RAYMOND SCALETTAR MD PLLC
Entity type:Organization
Organization Name:RAYMOND SCALETTAR MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-414-9207
Mailing Address - Street 1:3 WASHINGTON CIR NW STE 303
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-2311
Mailing Address - Country:US
Mailing Address - Phone:202-223-8911
Mailing Address - Fax:202-331-1489
Practice Address - Street 1:3 WASHINGTON CIR NW STE 303
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-2311
Practice Address - Country:US
Practice Address - Phone:202-223-8911
Practice Address - Fax:202-331-1489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCG01557Medicare PIN