Individual
KEITH BRIAN MASTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6845 LEE AVE N, BROOKLYN CENTER, MN 55429-1717
(763) 503-4400
(763) 503-4395
Mailing address
6845 LEE AVE N, BROOKLYN CENTER, MN 55429-1717
(763) 503-4400
(763) 503-4395
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27701
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
802272100
—
MN
Enumeration date
02/21/2006
Last updated
12/28/2015
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