Individual
DR. SCOTT D. WISSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9601 BLACKWELL RD STE 300, ROCKVILLE, MD 20850-3472
(301) 563-9333
(240) 800-1950
Mailing address
3342 QUESADA ST NW, WASHINGTON, DC 20015-1665
(301) 563-9333
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D59935
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213221400
—
MD
Enumeration date
02/17/2006
Last updated
08/22/2020
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