Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | 44259 | MN |
Y | 2084N0400X | Neurologist | 8834 | ND |
NPI | 1023039245 |
---|---|
Provider Name | Susan L Scarberry |
First Address | Fargo, ND 58103-1802 |
Second Address | Fargo, ND 58103-1802 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2006 |
Last Update Date | 01/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11663 | (05) | ND |
704410100 | (05) | MN |
F85132 | (02) |