Gregerson, Mark Conrad

Gregerson, Mark Conrad is an individual health care provider with primary practice located at 4572 County Road 61 , Moose Lake MN 55767-9401. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Gregerson, Mark Conrad can be contacted via phone (218) 485-4481.

Contact Information

Primary practice address
4572 County Road 61 Moose Lake MN 55767-9401
Phone: (218) 485-4481
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 29943 Minnesota

Profile Details

NPI number 1508809930
LBN Legal business name Gregerson, Mark Conrad
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2006
Last updated Nov 1st, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508809930 NPPES
Minnesota MEDICAID 441280000

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