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Individual

MARK GRADY CATLIN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2664 PATTON RD, ROSEVILLE, MN 55113
(651) 635-9700
(651) 635-9026
Mailing address
PO BOX 1450, NW 5737, MINNEAPOLIS, MN 55485-5737

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
29059
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02542CA
BCBS
MN
Enumeration date
03/25/2006
Last updated
07/08/2007
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