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Individual

MARK A SHANFELD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1611 ANNE ST NW, BEMIDJI, MN 56601-5114
(218) 333-2020
Mailing address
1611 ANNE ST NW, BEMIDJI, MN 56601-5114
(218) 333-2020

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
36199
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0829867
MEDICA
01
1011211
PREFERREDONE
01
28645
NDBCBS
ND
05
693363700
MN
01
HP57665
HEALTHPARTNERS
Enumeration date
01/31/2007
Last updated
11/21/2011
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