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General NPI Number Information
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NPI Number | 1750430823
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Entity Type | Individual
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Provider Name | MARK PHILLIP STESIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 3366 OAKDALE AVE N STE 409
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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 | 763-582-1800
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Fax | 763-582-1860
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Provider Business Mailing Address
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Address Line | 3366 OAKDALE AVE N STE 409
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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 | 763-582-1800
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Fax | 763-582-1860
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 26308
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License Number State | MN
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