Susan Marie Scufsa
Individual provider Active NPI Lodging Provider · Ely, MN
NPI 1962589994 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1962589994
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Lodging Provider 177F00000X
- License
- 1019569-1-AFC (MN)
- Practice address
- 2043 North Dr
Ely, MN 55731-8281 - Phone
- (218) 365-5305
- Fax
- (218) 365-2166
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1019569-1-AFC | MN | MD | Lodging Provider |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lodging Provider | 177F00000X | 1019569-1-AFC | MN | Yes |
Addresses
Primary practice location
2043 North Dr
Ely, MN 55731-8281
Mailing address
2043 North Dr
Ely, MN 55731-8281
Phone (218) 365-5305
Other providers in Ely, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.