Provider Demographics
NPI:1275684771
Name:LASTRAPES, SCOTT CHRISTOPHER (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:CHRISTOPHER
Last Name:LASTRAPES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 MERRIWEATHER DR UNIT 7072
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-4468
Mailing Address - Country:US
Mailing Address - Phone:240-383-0428
Mailing Address - Fax:
Practice Address - Street 1:14636 ROTHGEB DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-5394
Practice Address - Country:US
Practice Address - Phone:301-762-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-13
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD036365207Q00000X
MDD0065625207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine