Scallon, Stephen Mark

Scallon, Stephen Mark is an individual health care provider with primary practice located at 1500 Curve Crest Blvd W , Stillwater MN 55082-6040. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Scallon, Stephen Mark can be contacted via phone (651) 439-1234.

Contact Information

Primary practice address
1500 Curve Crest Blvd W Stillwater MN 55082-6040
Phone: (651) 439-1234
Fax: (651) 439-1547
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 24613 Wisconsin
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 29155 Minnesota

Profile Details

NPI number 1003899089
LBN Legal business name Scallon, Stephen Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 23rd, 2005
Last updated Jul 8th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003899089 NPPES
Minnesota MEDICAID 179773500
Minnesota MEDICAID 30626700

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