Individual
DR. MARK STEVEN WILKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9900 13TH AVENUE N, STE 2A, PLYMOUTH, MN 55441-5035
(763) 525-0363
(763) 525-0369
Mailing address
3316 W 66TH ST, STE 200, EDINA, MN 55435-2544
(763) 525-0363
(763) 525-0369
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
37708
MN
207ZP0101X
Anatomic Pathology Physician
37708
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
048218800
—
MN
Enumeration date
05/24/2005
Last updated
06/12/2017
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