Provider Demographics
NPI:1285752055
Name:PODRATZ, SCOTT K (PA-C)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:K
Last Name:PODRATZ
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:10001 W INNOVATION DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4851
Mailing Address - Country:US
Mailing Address - Phone:888-938-3838
Mailing Address - Fax:888-919-1083
Practice Address - Street 1:8401 SEASONS PKWY STE 300
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-3476
Practice Address - Country:US
Practice Address - Phone:888-938-3838
Practice Address - Fax:888-919-1083
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2023-05-23
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Provider Licenses
StateLicense IDTaxonomies
MN9027363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant