Healthcare Provider Details

I. General information

NPI: 1467568501
Provider Name (Legal Business Name): MARK N AHRENDT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NORTH MEMORIAL HEALTH CARE 3300 OAKDALE AVE NORTH
ROBBINSDALE MN
55422
US

IV. Provider business mailing address

NORTH MEMORIAL TRAUMA SERVICES 3300 OAKDALE AVE NORTH
ROBBINSDALE MN
55422
US

V. Phone/Fax

Practice location:
  • Phone: 763-520-7647
  • Fax: 763-520-1022
Mailing address:
  • Phone: 763-520-7647
  • Fax: 763-520-1022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number33948
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: