Provider Demographics
NPI:1295320935
Name:SCOTT LEPRE MD LLC
Entity type:Organization
Organization Name:SCOTT LEPRE MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:LEPRE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-219-5562
Mailing Address - Street 1:2402 VINEYARD SPRINGS WAY
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-6700
Mailing Address - Country:US
Mailing Address - Phone:215-219-5562
Mailing Address - Fax:
Practice Address - Street 1:2402 VINEYARD SPRINGS WAY
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-6700
Practice Address - Country:US
Practice Address - Phone:215-219-5562
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation