Individual
MARK S DWYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1611 ANNE ST NW, BEMIDJI, MN 56601-5114
(218) 333-2020
(218) 333-2019
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
34382
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
783008400
—
MN
Enumeration date
07/18/2006
Last updated
10/19/2023
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