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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MARK S MELLSTROM MD PA

Active Organization

MARK S MELLSTROM MD PA is a Primary Care Clinic organization located in LAKEVILLE, Minnesota. NPI 1629244686 is currently active in the NPPES registry. Verify at CMS.

Primary Care Clinic · LAKEVILLE, MN

Registration Details

NPI Number
1629244686
Provider Type
Organization
NPI Issued
Apr 30, 2008 (18.325619097448 yrs)
Last Updated
Apr 30, 2008
License
6208286 (MN)

Practice Information

Address
20157 ICENIC TRAIL
LAKEVILLE, MN, 55044
Browse MN providers · Browse ZIP 55044
Phone
9524693393
Fax
9524693399
Primary Specialty
Primary Care Clinic
261QP2300X

Other Primary Care Clinic Organizations in LAKEVILLE, MN

Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.