Provider Demographics
NPI:1548393234
Name:SCOTT, CHRISTOPHER MARK (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:MARK
Last Name:SCOTT
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 1:1000 EAST HIGH STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902-4848
Mailing Address - Country:US
Mailing Address - Phone:434-296-0113
Mailing Address - Fax:
Practice Address - Street 1:1000 EAST HIGH STREET
Practice Address - Street 2:SUITE B
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-4848
Practice Address - Country:US
Practice Address - Phone:434-296-0113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101241283207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1215018031OtherGROUP NPI
VA1215018031OtherGROUP NPI