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Individual

TIMOTHY M SCANLAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4767 DAHLIA WAY N, HUGO, MN 55038-6060
(651) 493-4856
Mailing address
4767 DAHLIA WAY N, HUGO, MN 55038-6060
(651) 493-4856

Taxonomy

Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
17663
KS
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
20245
MN

Other

Enumeration date
09/27/2005
Last updated
11/27/2012
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