MEDICARE: DR. WALTER SCOTT YOUNG III M.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
1	2084N0400X	Neurology Physician	D0021220	MD
2	2084N0400X	Neurology Physician	0101033531	VA

General Provider Information

NPI Number	:	1942448469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WALTER SCOTT YOUNG III M.D.

Provider Business Mailing Address
First Line	:	11116 PINION CT
Second Line	:
City	:	NORTH POTOMAC
State	:	MD
Zip	:	20878-2565
Country	:	US
Telephone Number	:	301-340-0126
Fax Number	:

Provider Business Practice Location Address
First Line	:	11116 PINION CT
Second Line	:
City	:	NORTH POTOMAC
State	:	MD
Zip	:	20878-2565
Country	:	US
Telephone Number	:	301-340-0126
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2009
Last Update Date	:	01/22/2009

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