Mark Kenyon Belknap
Individual provider Active NPI Internal Medicine Physician · Ashland, WI
NPI 1164582938 · NPPES record last updated May 9, 2011
Key facts
- NPI
- 1164582938
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 24356-020 (WI)
- Practice address
- 1625 Maple LN
Ashland, WI 54806-3768 - Phone
- (715) 685-7500
- NPI assigned
- Dec 11, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24356-020 | WI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Duluth Clinic, LTD. | Past | Accepting new patients | |
| The Duluth Clinic, LTD | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 24356-020 | WI | Yes |
Addresses
Primary practice location
1625 Maple LN
Ashland, WI 54806-3768
Mailing address
1625 Maple LN
Ashland, WI 54806-3768
Phone (715) 685-7500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 716436000 | Medicaid | MN |
Other providers in Ashland, WI
- Bay Area Rural Transit
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- Leo E Bay
- Rachel Elizabeth Bebeau
- Luke Beirl
- Robin Ann Belsky
- Judith A Bennington
- Laura Berg
- Amy Marie Berger
- Charles Kendall Bertel
All providers in Ashland, WI · Internal Medicine Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 9, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.