Healthcare Provider Details

I. General information

NPI: 1801538863
Provider Name (Legal Business Name): CESSAR SCOTT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2022
Last Update Date: 04/11/2022
Certification Date: 03/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 NORTH GEORE MASON DRIVE
ARLINGTON VA
20003
US

IV. Provider business mailing address

1025 1ST ST SE APT 913
WASHINGTON DC
20003-5327
US

V. Phone/Fax

Practice location:
  • Phone: 804-307-5333
  • Fax:
Mailing address:
  • Phone: 804-307-5333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: CESSAR L SCOTT
Title or Position: OWNER
Credential: MD
Phone: 804-307-5333