Individual
DR. MARK SPENCER HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9801 DUPONT AVE S, 425, BLOOMINGTON, MN 55431-3100
(952) 888-5800
Mailing address
9801 DUPONT AVE S, 425, BLOOMINGTON, MN 55431-3100
(952) 888-5800
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
2013-00778
NC
207W00000X
Ophthalmology Physician
Primary
57762
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/13/2009
Last updated
06/13/2014
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