Individual
MARK WAYNE BINGHAM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1202 5TH GRANT BLVD, WABASHA, MN 55981-1042
(651) 565-4571
Mailing address
1202 5TH GRANT BLVD, WABASHA, MN 55981-1042
(651) 565-4571
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10115
MN
Other
Enumeration date
06/13/2006
Last updated
07/08/2007
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