Provider Demographics
NPI:1457368771
Name:STROME, SCOTT ERIC (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ERIC
Last Name:STROME
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 64693
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4742
Mailing Address - Country:US
Mailing Address - Phone:410-328-6897
Mailing Address - Fax:410-328-2109
Practice Address - Street 1:1325 EASTMORELAND AVE STE 260
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-7549
Practice Address - Country:US
Practice Address - Phone:901-272-6051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN58056207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD2517945OtherUNITED HLTHCARE NATIONAL
MDK619OtherCAREFIRST REGIONAL
MD92119OtherGEISINGER
MD247173OtherKAISER
MD64608601OtherBLUE SHIELD
MD1001684OtherUNITED HLTHCARE
MD3129590OtherMDIPA
MD406818100Medicaid
MD1001684OtherUNITED HLTHCARE
MDG53632Medicare UPIN