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General NPI Number Information
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NPI Number | 1154355667
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Entity Type | Individual
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Provider Name | SCOTT E RUNDE DPM
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Gender | Male
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 05/04/2018
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Provider Practice Location Address
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Address Line | 919 NORTHLAND DR
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City | PRINCETON
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State | MN
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Zip | 55371-2172
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Country | US
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Telephone | 763-389-6353
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Fax | 763-389-7688
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Provider Business Mailing Address
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Address Line | 919 NORTHLAND DR
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City | PRINCETON
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State | MN
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Zip | 55371-2172
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Country | US
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Telephone | 763-389-6353
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Fax | 763-389-7688
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | MN733
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License Number State | MN
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