Individual
MARK KASSEBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1013 HART BLVD, MONTICELLO, MN 55362-8575
(612) 670-0610
Mailing address
1013 HART BLVD, MONTICELLO, MN 55362-8575
(612) 670-0610
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
33240
MN
Other
Enumeration date
10/10/2006
Last updated
03/27/2019
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