Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 50947 | MN |
NPI | 1013103837 |
---|---|
Provider Name | Dr. Scott Paul Prawer |
First Address | Fridley, MN 55432-3134 |
Second Address | Fridley, MN 55432-3134 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2007 |
Last Update Date | 29/03/2010 |