Healthcare Provider Details

I. General information

NPI: 1528197134
Provider Name (Legal Business Name): STEVEN JOSEPH SCHERGER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3111 124TH AVE NW
COON RAPIDS MN
55433-1793
US

IV. Provider business mailing address

12796 VERDIN ST NW
COON RAPIDS MN
55448-1293
US

V. Phone/Fax

Practice location:
  • Phone: 763-236-8911
  • Fax:
Mailing address:
  • Phone: 763-767-3953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number5766
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: