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Individual

MARK F LUDES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1216 RYANS RD, WORTHINGTON, MN 56187-1722
(507) 372-2921
(507) 372-5789
Mailing address
1216 RYANS RD, WORTHINGTON, MN 56187-1722
(507) 372-2921
(507) 372-5789

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
40058
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
125698
UCARE
MN
05
1916122
IA
01
370011044
RR MEDICARE
MN
01
54A06LU
BCBS MPIN
MN
05
863717200
MN
Enumeration date
10/03/2006
Last updated
05/26/2015
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