Provider Demographics
NPI:1932261070
Name:SCOTTINO, MARY ANNE (MD)
Entity Type:Individual
Prefix:
First Name:MARY ANNE
Middle Name:
Last Name:SCOTTINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8356 SAND CHERRY LN
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-1087
Mailing Address - Country:US
Mailing Address - Phone:301-604-3416
Mailing Address - Fax:775-206-1538
Practice Address - Street 1:8356 SAND CHERRY LN
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20723-1087
Practice Address - Country:US
Practice Address - Phone:301-604-3416
Practice Address - Fax:775-206-1538
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0036851207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine