MARK S MELLSTROM, MD, PA
Organization (NPI-2)
Active
Family Medicine
Provider Information
- NPI Number
1639340409- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 20157 ICENIC TRL, LAKEVILLE, MN, 550447708
- Phone
- (952) 469-3393
- Fax
- (952) 469-3399
Specialties & Taxonomies
Family Medicine
Primary License: MN #27926