Mark Kenneth Widstrom in Duluth - Obstetrics & Gynecology
Mark Kenneth Widstrom - NPI 1689692758
Mark Kenneth Widstrom is a Obstetrics & Gynecology in Duluth, Minnesota. Mark Kenneth Widstrom practices all healthcare services and medical treatments related to Obstetrics & Gynecology. The NPI Number for Mark Kenneth Widstrom is 1689692758. The last update date is 2011-05-09.
Mark Kenneth Widstrom's current location address is 400 E 3rd St, Duluth, Minnesota. You can contact this provider via phone number 2187868364. The mailing address for Mark Kenneth Widstrom is 400 E 3rd St, Duluth, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mark Kenneth Widstrom |
|---|---|
| Address | 400 E 3rd St, Duluth, Minnesota |
| Phone Number | 2187868364 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1689692758 |
|---|---|
| Provider Enumeration Date | 2006-07-17 |
| Last Updated Date | 2011-05-09 |
Provider Mailing Address Detail
| Address | 400 E 3rd St |
|---|---|
| City | Duluth |
| State | Minnesota (MN) |
| Post Code | 558051951 |
| Phone Number | 2187868364 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Obstetrics & Gynecology |
|---|---|
| Taxonomy | 207V00000X |
| Licence No | 45497 |
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Definition: An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 34348400 | WI | -- | |
| 542440200 | MN | -- |
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What is the unique identification code assigned to Mark Kenneth Widstrom by the Centers for Medicare & Medicaid Services?
The Mark Kenneth Widstrom has been issued the NPI (National Provider Identifier) 1689692758. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Mark Kenneth Widstrom is located?
The Mark Kenneth Widstrom is situated at the following address: 400 E 3Rd St, Duluth, MN, 558051951.
What is the Mark Kenneth Widstrom's specialty and taxonomy code?
The Mark Kenneth Widstrom's specialty is Obstetrics & Gynecology, and the corresponding taxonomy code is 207V00000X.
On what date did the Mark Kenneth Widstrom receive the assignment of its 1689692758 from the Centers for Medicare & Medicaid Services?
The Mark Kenneth Widstrom was issued its 1689692758 by the Centers for Medicare & Medicaid Services on 2006-07-17.
When was the Mark Kenneth Widstrom's information last updated?
The Mark Kenneth Widstrom's information was last updated on 2011-05-09.
NPI Number: 1982607784
Address: 54045 Ridge Rd, Yucca Valley, CA