Individual
DR. MARK MCMILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
250 THOMPSON ST, SAINT PAUL, MN 55102-2370
(651) 292-2000
(651) 292-2136
Mailing address
2355 HIGHWAY 36 W STE 100, ROSEVILLE, MN 55113-3905
(651) 292-2000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
41009
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
091016300
—
MN
Enumeration date
07/17/2006
Last updated
07/20/2021
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