Doctor Name: | DR. PRISCILLA SCANLON |
NPI Number: | 1649347279 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | D0053492 |
Business Practice Address: | 1550 Tomcat Blvd Ste 150 Virginia Beach, VA - 234602186 |
Business Phone Number: | 7573147028 |
Business Fax Number: | |
Mailing Address: | 1550 Tomcat Blvd Ste 150, VIRGINIA BEACH |
State: | VA |
Postal Code: | 234602186 |
Phone Number: | 7573147028 |
Fax Number: | |
NPI Enumeration Date: | 11/29/2006 |
NPI Last Update Date: | 11/13/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171000000X |
License Number: | D0053492 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Military Health Care Provider |
Taxonomy Specialization: | |
Taxonomy Definition: | Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |