Dr. Stephen Mark Scallon
Pediatrician
1500 Curve Crest Blvd W
Stillwater
, Minnesota 55082-6040
Dr. Stephen Mark Scallon
Pediatrician
1500 Curve Crest Blvd W
Stillwater
, Minnesota 55082-6040
(651) 439-1234
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About
Features
Specialties
- Pediatrician
Languages spoken
- English
Location
First Address
- Dr. Stephen Mark Scallon
- 8170 33rd Ave S # Ms 21110q
- Minneapolis, MN
- Zip : 55425-4516
- Phone : (651) 439-1234
Second Address
- Dr. Stephen Mark Scallon
- 1500 Curve Crest Blvd W
- Stillwater, MN
- Zip : 55082-6040
- Fax : (651) 439-1547
- Phone : (651) 439-1234
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 208000000X | Pediatrician | 24613 | WI |
| Y | 208000000X | Pediatrician | 29155 | MN |
National Provider Identifier
| NPI | 1003899089 |
|---|---|
| Provider Name | Dr. Stephen Mark Scallon |
| First Address | Minneapolis, MN 55425-4516 |
| Second Address | Stillwater, MN 55082-6040 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/11/2005 |
| Last Update Date | 08/07/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 179773500 | (05) | MN |
| 30626700 | (05) | WI |
| A93931 | (02) | MN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.