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Contact Information

SCOTT J FAIRBAIRN, MD
3433 BROADWAY ST NE STE 300
MINNEAPOLIS, MN55413-1761
 Phone: 763-587-7737
 Fax: 763-587-7069
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for SCOTT J FAIRBAIRN · (Male)

NPI # 1174553747
Status Active
Credentials MD
Entity Individual
Enumeration date 07/03/2006
Last updated 05/21/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • MN License # 36278
  • MN Medicaid 072563300
Hospital affiliation(s)
  • PARK NICOLLET METHODIST HOSPITAL - (Acute Care)
    6500 EXCELSIOR BLVD
    SAINT LOUIS PARK, MN 55426
  • ST JOSEPH'S HOSPITAL - (Acute Care)
    45 WEST 10TH STREET
    SAINT PAUL, MN 55102
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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