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NPI Code Detail

MEDICARE: DR. SCOTT MONROE BOEKE DO

MEDICARE: DR. SCOTT MONROE BOEKE DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician57696MN

General Provider Information

NPI Number : 1902198740
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SCOTT MONROE BOEKE DO
Provider Business Mailing Address
First Line : 701 PARK AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55415-1623
Country : US
Telephone Number : 612-873-3000
Fax Number :
Provider Business Practice Location Address
First Line : 715 S 8TH ST
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55404-7530
Country : US
Telephone Number : 612-873-6963
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2011
Last Update Date : 04/15/2026

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