Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 258780 | NY |
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | H0092676 | MD |
NPI | 1609176452 |
---|---|
Provider Name | Dr. Katherine Jane Scoville |
First Address | Potomac, MD 20854-1950 |
Second Address | Potomac, MD 20854-1950 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2010 |
Last Update Date | 15/12/2021 |