Yamaguchi, Mark K
Yamaguchi, Mark K is an individual health care provider with primary practice located at 155 Radio Dr , Woodbury MN 55125-2619. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as his primary health care specialty. Yamaguchi, Mark K can be contacted via phone (952) 831-8742.Contact Information
Primary practice address
155 Radio Dr
Woodbury MN 55125-2619
Phone: (952) 831-8742
Fax: (952) 977-3459
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | 52910 | Minnesota |
Profile Details
| NPI number | 1033313580 |
|---|---|
| LBN Legal business name | Yamaguchi, Mark K |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 11th, 2007 |
| Last updated | Apr 13th, 2022 - about 4 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 | 1033313580 | NPPES |
| Wisconsin | MEDICAID | 1033313580 | |
| Wisconsin | Other | 000000614543 | |
| Wisconsin | MEDICAID | 1033313580 | |
| Wisconsin | MEDICAID | 200863980 |
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