Individual
SCOTT R MATTHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1316 N 10TH ST, SPEARFISH, SD 57783
(605) 642-3113
Mailing address
353 FAIRMONT BLVD, ATTEN MEDICAL STAFF SERVICES, RAPID CITY, SD 57701-6000
(605) 719-7109
(605) 719-1027
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CR000654
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CR000654
CRNA LICENSE
SD
Enumeration date
04/13/2007
Last updated
08/14/2012
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