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Individual

DR. MARK REID SPANBAUER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
111 17TH AVE E, ALEXANDRIA, MN 56308-3703
(320) 762-6072
(320) 762-6145
Mailing address
2800 CAMPUS DR, SUITE 150, PLYMOUTH, MN 55441-2606
(763) 201-0492

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
23646
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
115090
UCARE
MN
Enumeration date
10/27/2005
Last updated
04/28/2008
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