Individual
SCOTT J FAIRBAIRN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3433 BROADWAY ST NE STE 300, MINNEAPOLIS, MN 55413-1761
(763) 587-7737
(763) 587-7069
Mailing address
3433 BROADWAY ST NE STE 300, MINNEAPOLIS, MN 55413-1761
(763) 587-7737
(763) 587-7069
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
36278
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
072563300
—
MN
Enumeration date
07/03/2006
Last updated
05/21/2024
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