Mark S Mellstrom, Md, Pa in Lakeville - Family Medicine
Mark S Mellstrom, Md, Pa - NPI 1639340409
Mark S Mellstrom, Md, Pa is a Family Medicine in Lakeville, Minnesota. Mark S Mellstrom, Md, Pa practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Mark S Mellstrom, Md, Pa is 1639340409. The last update date is 2008-04-23.
Mark S Mellstrom, Md, Pa's current location address is 20157 Icenic Trl, Lakeville, Minnesota. You can contact this provider via phone number 9524693393 and fax number 9524693399. The mailing address for Mark S Mellstrom, Md, Pa is 20157 Icenic Trl, Lakeville, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Mark S Mellstrom, Md, Pa |
|---|---|
| Address | 20157 Icenic Trl, Lakeville, Minnesota |
| Phone Number | 9524693393 |
| Fax Number | 9524693399 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Mellstrom Stanley Mark |
| Credentials | M.D |
| Telephone Number | 9524693393 |
NPI Number Detail
| NPI Number | 1639340409 |
|---|---|
| Provider Enumeration Date | 2008-03-19 |
| Last Updated Date | 2008-04-23 |
Provider Mailing Address Detail
| Address | 20157 Icenic Trl |
|---|---|
| City | Lakeville |
| State | Minnesota (MN) |
| Post Code | 550447708 |
| Phone Number | 9524693393 |
| Fax Number | 9524693399 |
Provider's Primary Taxonomy Detail
| Speciality | Family Medicine |
|---|---|
| Taxonomy | 207Q00000X |
| Licence No | 27926 |
|
Definition: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine i |
|
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Mark S Mellstrom, Md, Pa by the Centers for Medicare & Medicaid Services?
The Mark S Mellstrom, Md, Pa has been issued the NPI (National Provider Identifier) 1639340409, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Mark S Mellstrom, Md, Pa is physically located?
The Mark S Mellstrom, Md, Pa is physically situated at the following address: 20157 Icenic Trl, Lakeville, MN, 550447708.
What is the area of specialization for Mark S Mellstrom, Md, Pa, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Mark S Mellstrom, Md, Pa is Family Medicine, and the corresponding taxonomy code that categorizes this area of expertise is 207Q00000X.
On what date did the Mark S Mellstrom, Md, Pa receive its 1639340409 assignment from the Centers for Medicare & Medicaid Services?
The Mark S Mellstrom, Md, Pa was assigned its 1639340409 by the Centers for Medicare & Medicaid Services on 2008-03-19.
When was the information pertaining to Mark S Mellstrom, Md, Pa most recently updated or revised?
The details related to Mark S Mellstrom, Md, Pa, including its address, specialty, and other relevant information, were last updated or revised on 2008-04-23.
NPI Number: 1336142389
Address: Po Box 2004, East Syracuse, NY