Individual
MARK A NAMMACHER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6600 EXCELSIOR BLVD, 131, ST LOUIS PARK, MN 55426-4744
(952) 401-8290
(952) 401-8243
Mailing address
4711 CEDARWOOD RD, MINNEAPOLIS, MN 55416-1970
(952) 929-7683
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
20132
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
145J4NA
BLUE CROSS BLUE SHIELD
MN
01
—
HP51758
HEALTH PARTNERS
MN
Enumeration date
04/17/2006
Last updated
07/09/2007
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