Provider Demographics
NPI:1316010028
Name:KAMPMANN, SCOT (DC)
Entity type:Individual
Prefix:
First Name:SCOT
Middle Name:
Last Name:KAMPMANN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 69105
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-9105
Mailing Address - Country:US
Mailing Address - Phone:443-842-5500
Mailing Address - Fax:667-309-6024
Practice Address - Street 1:6810 PARK HEIGHTS AVE STE C4
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-1662
Practice Address - Country:US
Practice Address - Phone:443-842-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1315111N00000X
MDS01729111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCF015-0004OtherBCBS DC
MD604053-02OtherBABC MARYLAND
DCF015-0004OtherBCBS DC
MD013036T30Medicare ID - Type Unspecified