Individual
DR. MARK MINTUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
R6C45
MO
2085N0904X
Nuclear Radiology Physician
Primary
R6C45
MO
Other
Enumeration date
10/03/2006
Last updated
08/10/2010
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