Provider Demographics
NPI:1063638922
Name:MONKS, WARREN SCOTT (PA-C)
Entity type:Individual
Prefix:
First Name:WARREN
Middle Name:SCOTT
Last Name:MONKS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 WYMAN PARK DR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-2803
Mailing Address - Country:US
Mailing Address - Phone:410-338-3500
Mailing Address - Fax:
Practice Address - Street 1:103 BATA BLVD STE A
Practice Address - Street 2:
Practice Address - City:BELCAMP
Practice Address - State:MD
Practice Address - Zip Code:21017-1420
Practice Address - Country:US
Practice Address - Phone:410-575-6611
Practice Address - Fax:410-575-7408
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0002793363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant