Susan L Mark, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

55708 Issued in MN

Practice address

2120 Ford Pkwy
Saint Paul, MN 55116-1863

Phone

(651) 241-9600

Fax

(651) 241-9593

NPI assigned

Apr 7, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Legacy Emanuel Hospital & Health Center

  dba Apothecary at Emanuel Hospital

  • Community/Retail Pharmacy
  • Portland, OR
  • NPI 1417977976
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373932800000",
    "number": "1225091606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 FORD PKWY",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551161863",
            "telephone_number": "651-241-9600",
            "fax_number": "651-241-9593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARK",
        "first_name": "SUSAN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-07",
        "last_updated": "2013-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "55708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038534",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John J Marini, MD
• Michael Lavern Maristuen, D.C.
• Mitchell Dale Maristuen, D.C
• Mark F. Lavallie, D.C.
• Mark I. Malterud, D.D.S., P.a.
• Jennifer Ann Marker Johnson, D.D.S.
• Ruth Brooke Markowitz, MA LICENSED PSYCHOLO
• Anne Marks, RN
• Anne Markus
• Gregory Marn, PHARM D

• Internal Medicine Physician in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Internal Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.