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Individual

MARK A MYERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1230 E MAIN ST, MANKATO CLINIC @ MAIN STREET, MANKATO, MN 56002-8674
(507) 625-1811
Mailing address
1230 E MAIN ST, PO BOX 8674, MANKATO, MN 56002-8674
(507) 625-1811

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
45804
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0568519
IA
01
097L1MY
BCBS
MN
01
1602454
MEDICA
MN
01
171361
UCARE
MN
01
2227442
AMERICAS PPO
MN
01
41084933956001C202
CHAMPUS
05
996422300
MN
01
HP37918
HEALTH PARTNERS
MN
01
NA2951022862
PREFERRED ONE
MN
01
P00039431
RR MEDICARE
Enumeration date
01/10/2006
Last updated
08/09/2011
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