Basic Information
| Provider Information | |||||||||
| NPI: | 1609824499 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REHRIG | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | THOMAS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | REHRIG | ||||||||
| OtherFirstName: | SCOTT | ||||||||
| OtherMiddleName: | THOMAS | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | JR. | ||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 11085 LITTLE PATUXENT PKWY | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | COLUMBIA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210442983 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107301988 | ||||||||
| FaxNumber: | 4107301987 | ||||||||
| Practice Location | |||||||||
| Address1: | 11085 LITTLE PATUXENT PKWY | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | COLUMBIA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210442983 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107301988 | ||||||||
| FaxNumber: | 4107301987 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2006 | ||||||||
| LastUpdateDate: | 04/09/2019 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | M | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 0101266368 | VA | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | 227155 | MA | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | MD069539L | PA | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | D0051484 | MD | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.