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Individual

MARK A SHOEMAKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C,SA-C

Contact information

Practice address
23671 SAINT FRANCIS BLVD NW, SUITE 104, SAINT FRANCIS, MN 55070-9802
(763) 753-8724
(763) 753-8725
Mailing address
23671 SAINT FRANCIS BLVD NW, SUITE 104, SAINT FRANCIS, MN 55070-9802
(763) 753-8724
(763) 753-8725

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8822
MN

Other

Enumeration date
11/20/2006
Last updated
07/08/2007
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