Provider Demographics
NPI:1306992433
Name:ISCKARUS, GEORGE SAMUEL (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:SAMUEL
Last Name:ISCKARUS
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 1:2227 OLD EMMORTON ROAD SUITE 220
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015
Mailing Address - Country:US
Mailing Address - Phone:410-569-9040
Mailing Address - Fax:844-569-0856
Practice Address - Street 1:2227 OLD EMMORTON ROAD SUITE 220
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015
Practice Address - Country:US
Practice Address - Phone:410-569-9040
Practice Address - Fax:844-569-0856
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0063220207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD408274500Medicaid
PA894314Medicare ID - Type Unspecified