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General NPI Number Information
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NPI Number | 1942228168
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Entity Type | Individual
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Provider Name | MARK R MIGLIORI MD
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 11/16/2023
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Provider Practice Location Address
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Address Line | 7450 FRANCE AVE S STE 220
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City | EDINA
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State | MN
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Zip | 55435-4792
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Country | US
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Telephone | 952-925-1111
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Fax | 952-942-3446
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Provider Business Mailing Address
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Address Line | 7450 FRANCE AVE S STE 220
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City | EDINA
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State | MN
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Zip | 55435-4792
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Country | US
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Telephone | 952-925-1111
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Fax | 952-922-3446
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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 | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 35467
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 35467
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License Number State | MN
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