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Individual

DR. SCOTT TYLER PERSELLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511

Taxonomy

Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
26602
MN
207RR0500X
Rheumatology Physician
ME51867
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05803
BLUECROSS/BLUESHIELD
FL
05
268820400
FL
01
700006030
RAILROAD MEDICARE
FL
Enumeration date
10/24/2005
Last updated
03/14/2018
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