Individual
DR. MARK S PALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
516 DELAWARE STREET SE, PWB, CLINIC 2A, UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55455
(612) 626-6100
Mailing address
420 DELAWARE ST SE,, UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55455
(612) 626-6100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
27179
MN
207RN0300X
Nephrology Physician
Primary
27179
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0051986
—
MT
05
—
0500553
—
IA
01
—
1009263
PREFERREDONE
—
01
—
101500
UCARE
—
05
—
168568600
—
MN
01
—
2T173PA
BLUECROSS BLUESHIELD
MN
05
—
30713400
—
WI
01
—
31-00005
MEDICA - PRIMARY
—
01
—
31-24565
MEDICA - CHOICE
—
01
—
768290
ARAZ
—
01
—
HP22172
HEALTHPARTNERS
—
Enumeration date
08/19/2006
Last updated
10/26/2012
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