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NPI Code Detail

MEDICARE: DR. SCOTT WILLARD SAUTTER PH.D.

MEDICARE:  DR. SCOTT WILLARD SAUTTER  PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103G00000XClinical Neuropsychologist
2103G00000XClinical Neuropsychologist810001696VA
3103G00000XClinical Neuropsychologist0810001696VA

General Provider Information

NPI Number : 1679520092
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SCOTT WILLARD SAUTTER PH.D.
Provider Business Mailing Address
First Line : 1604 HILLTOP WEST EXECUTIVE CENTER
Second Line : 216
City : VIRGINIA BEACH
State : VA
Zip : 23451
Country : US
Telephone Number : 757-498-9585
Fax Number : 757-468-1685
Provider Business Practice Location Address
First Line : 1604 HILLTOP WEST CTR STE 216
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23451-6131
Country : US
Telephone Number : 757-498-9585
Fax Number : 757-468-1685
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2006
Last Update Date : 10/24/2017

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Directions to “ DR. SCOTT WILLARD SAUTTER PH.D.” Practice Location

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