Individual
MARK L NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
901 S 2ND ST, MINNEAPOLIS, MN 55415-1289
(612) 338-1383
Mailing address
901 S 2ND ST, MINNEAPOLIS, MN 55415-1289
(612) 338-1383
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
62594
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/04/2016
Last updated
05/28/2019
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