Provider Demographics
NPI:1457380834
Name:RIFKIN, SCOTT M (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:M
Last Name:RIFKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1220A E JOPPA RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-5812
Mailing Address - Country:US
Mailing Address - Phone:410-828-6093
Mailing Address - Fax:443-279-0825
Practice Address - Street 1:1220A E JOPPA RD
Practice Address - Street 2:SUITE 230
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-5812
Practice Address - Country:US
Practice Address - Phone:410-828-6093
Practice Address - Fax:443-279-0825
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0034145207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC27429300Medicaid
MD935L440EMedicare ID - Type Unspecified
DC27429300Medicaid
DC000Z80R31Medicare ID - Type Unspecified
MD943L470EMedicare ID - Type Unspecified