Provider Demographics
NPI:1871908590
Name:DEBOER, SCOTT RICHARD (MD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:RICHARD
Last Name:DEBOER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9000 FRANKLIN SQUARE DR FL 2
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-3901
Mailing Address - Country:US
Mailing Address - Phone:443-777-7320
Mailing Address - Fax:443-777-8320
Practice Address - Street 1:9000 FRANKLIN SQUARE DR
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-3901
Practice Address - Country:US
Practice Address - Phone:443-777-7320
Practice Address - Fax:443-777-8320
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2020-05-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD00894442084A2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurocritical Care