Cannon, Mark Lawrence
Cannon, Mark Lawrence is an individual health care provider with primary practice located at 3366 Oakdale Ave N , Robbinsdale MN 55422-2948. He recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as his primary health care specialty. Cannon, Mark Lawrence can be contacted via phone (763) 520-5200.Contact Information
Primary practice address
3366 Oakdale Ave N
Robbinsdale MN 55422-2948
Phone: (763) 520-5200
Fax: (763) 581-6401
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | 206201 | New York |
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | 4301061767 | Michigan |
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | 39619 | Minnesota |
Profile Details
| NPI number | 1881805265 |
|---|---|
| LBN Legal business name | Cannon, Mark Lawrence |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 25th, 2007 |
| Last updated | Apr 18th, 2023 - about 3 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 | 1881805265 | NPPES |
| Michigan | MEDICAID | 1881805265 |
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