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Individual

MR. SCOTT KNUTSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
6625 LYNDALE AVE S STE 105, RICHFIELD, MN 55423-2673
(612) 788-8778
(612) 869-3473
Mailing address
6625 LYNDALE AVE S STE 300, RICHFIELD, MN 55423-2491
(612) 788-8778
(612) 869-3473

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
427
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0491043
IA
01
0808750001
MEDICARE DMERC
MN
05
213825500
MN
05
236266000
MN
01
480000572
TRAVELERS RAILROAD
MN
01
C02581
MEDICARE GROUP
MN
01
CS1038
TRAVELERS RAILROAD GROUP
MN
01
P00309735
MEDICARE RAILROAD
MN
Enumeration date
06/20/2005
Last updated
07/22/2019
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