Individual
DR. SCOTT T REARDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3000 32ND AVE S, FARGO, ND 58103-6132
(701) 364-8000
(701) 364-8078
Mailing address
PO BOX 6001, FARGO, ND 58108-6001
(701) 364-8000
(701) 364-8078
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
12676
ND
2085R0202X
Diagnostic Radiology Physician
3063410
MN
2085R0202X
Diagnostic Radiology Physician
51530
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18210
—
ND
Enumeration date
07/07/2006
Last updated
11/11/2013
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