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General NPI Number Information
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NPI Number | 1225187255
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Entity Type | Organization
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Legal Business Name | MARK P STESIN MD PA
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 3366 OAKDALE AVE N SUITE 408
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City | ROBBINSDALE
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State | MN
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Zip | 55422-2948
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Country | US
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Telephone | 763-520-5876
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Fax | 763-520-1703
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Provider Business Mailing Address
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Address Line | 3366 OAKDALE AVE N SUITE 408
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City | ROBBINSDALE
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State | MN
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Zip | 55422-2948
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Country | US
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Telephone | 763-520-5876
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Fax | 763-520-1703
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARK PHILIP STESIN
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Credential | MD
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Telephone | 763-520-5876
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 1250
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License Number State | MN
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