Provider Demographics
NPI:1861554974
Name:MAURER, SCOTT T (MD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:T
Last Name:MAURER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2465 STATE ROUTE 97
Mailing Address - Street 2:SUITE 10
Mailing Address - City:GLENWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:21738-9749
Mailing Address - Country:US
Mailing Address - Phone:410-489-9550
Mailing Address - Fax:410-489-5527
Practice Address - Street 1:2465 STATE ROUTE 97
Practice Address - Street 2:SUITE 10
Practice Address - City:GLENWOOD
Practice Address - State:MD
Practice Address - Zip Code:21738-9749
Practice Address - Country:US
Practice Address - Phone:410-489-9550
Practice Address - Fax:410-489-5527
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2022-11-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD29909207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD369411900Medicaid
MDLQ97JHOtherBCBS
MD996MMedicare ID - Type Unspecified
MDB67116Medicare UPIN