Healthcare Provider Details

I. General information

NPI: 1083532758
Provider Name (Legal Business Name): SCOTT PROESTEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8505 IRVINGTON AVE
BETHESDA MD
20817-3815
US

IV. Provider business mailing address

8505 IRVINGTON AVE
BETHESDA MD
20817-3815
US

V. Phone/Fax

Practice location:
  • Phone: 202-631-3283
  • Fax:
Mailing address:
  • Phone: 202-631-3283
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD0048108
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: