Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 50736 | MN |
NPI | 1326182551 |
---|---|
Provider Name | Dr. Mark Christopher Wilczynski |
First Address | Bloomington, MN 55431-4800 |
Second Address | Bloomington, MN 55431-4800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2007 |
Last Update Date | 16/04/2019 |