Wilke, Mark Steven
Wilke, Mark Steven is an individual health care provider with primary practice located at 9900 13Th Avenue N Ste 2A, Plymouth MN 55441-5035. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatopathology, Allopathic & Osteopathic Physicians / Anatomic Pathology. Allopathic & Osteopathic Physicians / Dermatopathology is his primary health care specialty. Wilke, Mark Steven can be contacted via phone (763) 525-0363.Contact Information
Primary practice address
9900 13Th Avenue N Ste 2A
Plymouth MN 55441-5035
Phone: (763) 525-0363
Fax: (763) 525-0369
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Dermatopathology | 207ZD0900X | 37708 | Minnesota |
Allopathic & Osteopathic Physicians / Anatomic Pathology | 207ZP0101X | 37708 | Minnesota |
Profile Details
NPI number | 1376546234 |
---|---|
LBN Legal business name | Wilke, Mark Steven |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 24th, 2005 |
Last updated | Jun 12th, 2017 - about 7 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1376546234 | NPPES |
Minnesota | MEDICAID | 048218800 |
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