MEDICARE: DR. MARK A. RAWSON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	35804	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407836224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK A. RAWSON M.D.

Provider Business Mailing Address
First Line	:	1342 COLORADO AVE S
Second Line	:
City	:	ST LOUIS PARK
State	:	MN
Zip	:	55416-1220
Country	:	US
Telephone Number	:	763-229-7350
Fax Number	:

Provider Business Practice Location Address
First Line	:	1342 COLORADO AVE S
Second Line	:
City	:	ST LOUIS PARK
State	:	MN
Zip	:	55416-1220
Country	:	US
Telephone Number	:	952-546-5322
Fax Number	:	763-210-6820

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	04/15/2025

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