Provider Demographics
NPI:1669577417
Name:REICHEL, SCOTT ANTHONY (MD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:ANTHONY
Last Name:REICHEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5502 W BROADWAY
Mailing Address - Street 2:NORTHWEST FAMILY PHYSICIANS
Mailing Address - City:CRYSTAL
Mailing Address - State:MN
Mailing Address - Zip Code:55428
Mailing Address - Country:US
Mailing Address - Phone:763-287-6500
Mailing Address - Fax:763-287-6544
Practice Address - Street 1:5502 W BROADWAY
Practice Address - Street 2:NORTHWEST FAMILY PHYSICIANS
Practice Address - City:CRYSTAL
Practice Address - State:MN
Practice Address - Zip Code:55428
Practice Address - Country:US
Practice Address - Phone:763-287-6500
Practice Address - Fax:763-287-6544
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN46838207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine