Individual
MARK D SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
715 S 8TH ST, MINNEAPOLIS, MN 55404-7530
(612) 873-6963
Mailing address
701 PARK AVE, MINNEAPOLIS, MN 55415-1623
(612) 873-3000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
65664
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2016
Last updated
07/31/2024
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