Individual
MARK E MYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5775 WAYZATA BLVD, SUITE 190, ST LOUIS PARK, MN 55416-1222
(952) 525-6328
(952) 513-6880
Mailing address
PO BOX 1414, NCB-6, MINNEAPOLIS, MN 55480-1414
(952) 525-6328
(952) 513-6880
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
33807
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
856303900
—
MN
Enumeration date
01/10/2006
Last updated
09/12/2007
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