Provider Demographics
NPI:1831695378
Name:BURSTYN, SCOTT BRIAN
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:BRIAN
Last Name:BURSTYN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-3592
Mailing Address - Country:US
Mailing Address - Phone:410-879-1212
Mailing Address - Fax:410-803-1859
Practice Address - Street 1:535 OLD WESTMINSTER PIKE STE 105
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-6267
Practice Address - Country:US
Practice Address - Phone:410-876-8180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-03
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01723213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist