| Doctor Name: | MR. SCOTT M MINOR |
| NPI Number: | 1023488871 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | 99069474A |
| Business Practice Address: | 270 E Day Rd Suite 200 Mishawaka, IN - 465453444 |
| Business Phone Number: | 5742715151 |
| Business Fax Number: | 5742715175 |
| Mailing Address: | 270 E Day Rd, Suite 200 MISHAWAKA |
| State: | IN |
| Postal Code: | 465453444 |
| Phone Number: | 5742715151 |
| Fax Number: | 5742715175 |
| NPI Enumeration Date: | 10/05/2015 |
| NPI Last Update Date: | 10/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 99069474A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |