Provider Demographics
NPI:1508807884
Name:CROWE, SCOTT CARL (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:CARL
Last Name:CROWE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MMC 297
Mailing Address - Street 2:420 DELEWARE ST. SE.
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-626-4050
Mailing Address - Fax:612-624-6686
Practice Address - Street 1:MMC 297
Practice Address - Street 2:420 DELEWARE ST SE
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455
Practice Address - Country:US
Practice Address - Phone:612-626-4050
Practice Address - Fax:612-624-6686
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN48441208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNI54539Medicare UPIN