Provider Demographics
NPI:1831157379
Name:MACLEOD, SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:MACLEOD
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 1:499 HILLCREST RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22824-2923
Mailing Address - Country:US
Mailing Address - Phone:540-984-8694
Mailing Address - Fax:
Practice Address - Street 1:1195 HISEY AVE
Practice Address - Street 2:HIGHLANDER FAMILY MEDICINE
Practice Address - City:WOODSTOCK
Practice Address - State:VA
Practice Address - Zip Code:22664
Practice Address - Country:US
Practice Address - Phone:540-459-2277
Practice Address - Fax:540-459-3309
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101052455207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005645964Medicaid
VA00W944H01Medicare PIN
G35089Medicare UPIN