Individual
MARK P MOGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
105 S STATE ST, SUITE 113, ABERDEEN, SD 57401-4500
(605) 225-0378
(605) 225-7919
Mailing address
PO BOX 1460, ABERDEEN, SD 57402-1460
(605) 225-0378
(605) 225-7919
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1379
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1379
—
ND
05
—
5603473
—
SD
05
—
5603474
—
SD
Enumeration date
06/09/2005
Last updated
09/02/2009
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