Individual
DR. MARK R GUNDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
712 SOUTH CASCADE STREET, FERGUS FALLS, MN 56537-2813
(218) 736-8000
(218) 739-6742
Mailing address
1216 RYANS RD, WORTHINGTON, MN 56187-1722
(507) 372-2921
(507) 372-6523
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35677
MN
207Q00000X
Family Medicine Physician
4301069187
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010G56026
HEALTH PLUS
MI
01
—
080093188
METRAHEALTH
MI
01
—
0802502771
BLUE CROSS BLUE SHIELD
MI
01
—
080D410020
BLUE CROSS BLUE SHIELD
MI
01
—
204375
MCLAREN HEALTH PLAN
MI
05
—
4540600
—
MI
01
—
5659321
AETNA
MI
01
—
7073962004
CIGNA
MI
01
—
C4258
MCARE
MI
01
—
F31478
HEALTH NET FEDERAL
MI
Enumeration date
10/20/2005
Last updated
10/29/2019
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