Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 107809 | MN |
N | 208600000X | Surgeon | 107809 | MN |
N | 2086S0120X | Pediatric Surgery | 01039396A | IN |
N | 2086S0120X | Pediatric Surgery | 036-154839 | IL |
N | 2086S0120X | Pediatric Surgery | 55798 | KY |
N | 2086S0120X | Pediatric Surgery | LT-4111 | NH |
N | 2086S0120X | Pediatric Surgery | MD60667533 | WA |
Y | 2086S0120X | Pediatric Surgery | TP372 | KY |
NPI | 1154391142 |
---|---|
Provider Name | L R Scherer III |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2006 |
Last Update Date | 22/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100321250 | (05) | IN |
D74436 | (02) |