Provider Demographics
NPI:1588657019
Name:NAGELL, SCOTT HOWARD (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:HOWARD
Last Name:NAGELL
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 1:224-D CORNWALL STREET, NW, SUITE 403
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-2704
Mailing Address - Country:US
Mailing Address - Phone:703-737-6010
Mailing Address - Fax:703-443-8643
Practice Address - Street 1:44084 RIVERSIDE PARKWAY, SUITE 300
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-5155
Practice Address - Country:US
Practice Address - Phone:703-724-7530
Practice Address - Fax:703-858-2870
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101043278207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA080156025OtherRR MEDICARE
VA1588657019Medicaid
VA5607345Medicaid
VA30015775320001Medicaid