Individual
DR. SUSAN L MARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2120 FORD PKWY, SAINT PAUL, MN 55116-1863
(651) 241-9600
(651) 241-9593
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
55708
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038534
—
OR
Enumeration date
04/07/2006
Last updated
07/16/2013
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