Provider Demographics
NPI:1225103229
Name:FORREST, SCOTT T (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:T
Last Name:FORREST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10721 MAIN ST
Mailing Address - Street 2:#200
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030
Mailing Address - Country:US
Mailing Address - Phone:703-385-6870
Mailing Address - Fax:703-385-6875
Practice Address - Street 1:10721 MAIN ST
Practice Address - Street 2:#200
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030
Practice Address - Country:US
Practice Address - Phone:703-385-6870
Practice Address - Fax:703-385-6875
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101056301207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
7348149OtherAETNA
3574063OtherAETNA HMO
0101056301OtherMEDICAL LICENSE NUMBER
517580002OtherCAREFIRST BCBS BLUE CHOIC
2125649OtherMAMSI
503342OtherNCPPO
J7580002OtherCAREFIRST BCBS BLUE CHOIC
138983OtherANTHEM BCBS
138983OtherANTHEM BCBS