Healthcare Provider Details

I. General information

NPI: 1750550851
Provider Name (Legal Business Name): SCOTT MICHAEL EVERSON DO, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2008
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2094 TWIN SIX LN
DUMFRIES VA
22026-3008
US

IV. Provider business mailing address

2094 TWIN SIX LN
DUMFRIES VA
22026-3008
US

V. Phone/Fax

Practice location:
  • Phone: 240-997-5862
  • Fax:
Mailing address:
  • Phone: 937-369-7982
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number0102207681
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number0102207681
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number02003557A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: