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General NPI Number Information
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NPI Number | 1407963598
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Entity Type | Individual
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Provider Name | S SCOTT STANDA
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Gender | Male
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 02/26/2010
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Provider Practice Location Address
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Address Line | 287 MARSCHALL RD STE 106
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City | SHAKOPEE
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State | MN
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Zip | 55379-1686
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Country | US
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Telephone | 952-445-5390
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Fax | 952-445-5394
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Provider Business Mailing Address
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Address Line | 287 MARSCHALL RD STE 106
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City | SHAKOPEE
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State | MN
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Zip | 55379-1678
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Country | US
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Telephone | 952-445-5390
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Fax | 952-445-5394
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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 | 334
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License Number State | MN
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