Individual
MICHAEL SANFORD VAN SCOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2000 44TH ST S STE 201&203, FARGO, ND 58103-7411
(218) 786-8364
Mailing address
2000 44TH ST S STE 201&203, FARGO, ND 58103-7411
(480) 494-2465
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
37704
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32057300
—
WI
05
—
713727300
—
MN
Enumeration date
07/17/2006
Last updated
03/13/2024
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