Individual
SCOTT MYRON HOLTHUSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
560 S MAPLE ST, SUITE 200, WACONIA, MN 55387-1733
(952) 442-2163
Mailing address
560 S MAPLE ST, SUITE 200, WACONIA, MN 55387-1733
(952) 442-2163
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
4301085937
MI
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
54138
MN
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
MD 60132138
WA
Other
Enumeration date
05/22/2007
Last updated
08/09/2011
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