Basic Information
| Provider Information | |||||||||
| NPI: | 1568559177 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CROW | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | UNIVERSITY OF MINNESOTA PHYSICIANS | ||||||||
| Address2: | 420 DELAWARE ST SE | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55455 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6122738700 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2312 SOUTH 6TH STREET | ||||||||
| Address2: | SUITE F256 / 2B WEST | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55454 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6122738700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2006 | ||||||||
| LastUpdateDate: | 05/13/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 033047 | MN | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 768073 | 01 | MN | ARAZ | OTHER | 1515881 | 01 | MN | MEDICA-PRIMARY | OTHER | 1515881 | 01 | MN | MEDICA-CHOICE | OTHER | 8D920CR | 01 | MN | BLUE CROSS BLUE SHIELD | OTHER | HP20728 | 01 | MN | HEALTH PARTNERS | OTHER | 086769 | 01 | MN | FAIRVIEW | OTHER | 102730 | 01 | MN | U CARE | OTHER | 979867600 | 05 | MN | MEDICAID | 1006904 | 01 | MN | PREFERRED ONE | OTHER |