Individual
MARK K YAMAGUCHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
155 RADIO DR, WOODBURY, MN 55125-2619
(952) 831-8742
(952) 977-3459
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
52910
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000614543
ANTHEM PROVIDER NUMBER
IN
05
—
1033313580
—
MN
05
—
1033313580
—
WI
05
—
200863980
—
IN
Enumeration date
06/11/2007
Last updated
04/13/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us