Provider Demographics
NPI:1669486874
Name:APTED, SCOTT H (OD)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:H
Last Name:APTED
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:5943 CENTREVILLE CREST LN
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20121-2344
Mailing Address - Country:US
Mailing Address - Phone:703-815-2020
Mailing Address - Fax:703-815-2020
Practice Address - Street 1:5943 CENTREVILLE CREST LN
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20121-2344
Practice Address - Country:US
Practice Address - Phone:703-815-2020
Practice Address - Fax:703-815-2020
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0601001335152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA92-3756-9Medicaid
VA92-3756-9Medicaid