Healthcare Provider Details

I. General information

NPI: 1881336766
Provider Name (Legal Business Name): BENJAMIN SCOTT II MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2022
Last Update Date: 04/11/2022
Certification Date: 04/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WALTER REED NATIONAL MILITARY MEDICAL 8901 WISCONSIN AVENUE
BETHESDA MD
20889
US

IV. Provider business mailing address

WALTER REED NATIONAL MILITARY MEDICAL 8901 WISCONSIN AVENUE
BETHESDA MD
20889
US

V. Phone/Fax

Practice location:
  • Phone: 301-400-2185
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: