Individual
DR. MARK LAWRENCE CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3366 OAKDALE AVE N, ROBBINSDALE, MN 55422-2948
(763) 520-5200
(763) 581-6401
Mailing address
3300 OAKDALE AVE N, ROBBINSDALE, MN 55422-2926
(763) 520-5200
(763) 581-6401
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
206201
NY
207RI0200X
Infectious Disease Physician
Primary
39619
MN
207RI0200X
Infectious Disease Physician
4301061767
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881805265
—
MI
Enumeration date
05/25/2007
Last updated
04/18/2023
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