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Individual

MARCINE P ELLWEIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
610 30TH AVE W, ALEXANDRIA, MN 56308-3426
(320) 763-5123
(320) 763-7883
Mailing address
610 30TH AVE W, ALEXANDRIA, MN 56308-3426
(320) 763-5123
(320) 763-7883

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
48447
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
096408000
MN
Enumeration date
10/18/2006
Last updated
10/10/2012
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