Individual
DR. MARK HENRY GOELLNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1001 E SUPERIOR ST, SUITE L401, DULUTH, MN 55802-2207
(218) 249-7960
Mailing address
1001 E SUPERIOR ST, SUITE L401, DULUTH, MN 55802-2207
(218) 249-7960
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
31042
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110235254
MEDICARE RR
MN
05
—
139885700
—
MN
Enumeration date
05/12/2006
Last updated
10/23/2007
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