Healthcare Provider Details

I. General information

NPI: 1659275287
Provider Name (Legal Business Name): ADAM GENE SCOW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 7TH ST W STE 1F-121B
DICKINSON ND
58601-4335
US

IV. Provider business mailing address

2005 YELLOWSTONE CIR
DICKINSON ND
58601-3001
US

V. Phone/Fax

Practice location:
  • Phone: 701-402-3335
  • Fax:
Mailing address:
  • Phone: 701-495-4714
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License NumberSCO874273
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: