Individual
DR. MARK H EIKENBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2530 CHICAGO AVE S, SUITE 400, MINNEAPOLIS, MN 55404-4387
(612) 813-3300
(612) 813-3349
Mailing address
2530 CHICAGO AVE S, SUITE 400, MINNEAPOLIS, MN 55404-4387
(612) 813-3300
(612) 813-3349
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
31493
AZ
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
42311
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
798621
—
AZ
Enumeration date
02/10/2006
Last updated
02/28/2011
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