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NPI Code Detail

MEDICARE: MARK M VINT

MEDICARE: MARK M VINT
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
1207Q00000XFamily Medicine Physician47813MN

General Provider Information

NPI Number : 1508835422
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK M VINT
Provider Business Mailing Address
First Line : 3300 FREMONT AVE N
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55412-2405
Country : US
Telephone Number : 612-588-9411
Fax Number : 612-588-8066
Provider Business Practice Location Address
First Line : 3300 FREMONT AVE N
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55412-2405
Country : US
Telephone Number : 612-588-9411
Fax Number : 612-588-8066
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2006
Last Update Date : 06/02/2013

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Directions to “ MARK M VINT ” Practice Location

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