| Mark S Dwyer, MD | |
|
1611 Anne St Nw, Bemidji, MN 56601-5114 | |
| (218) 333-2020 | |
| (218) 333-2019 |
| Full Name | Mark S Dwyer |
|---|---|
| Gender | Male |
| Speciality | Ophthalmology |
| Location | 1611 Anne St Nw, Bemidji, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962420505 | NPI | - | NPPES |
| 783008400 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207W00000X | Ophthalmology | 34382 (Minnesota) | Primary |
| Entity Name | Sanford Health Of Northern Minnesota |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770849697 PECOS PAC ID: 5597725168 Enrollment ID: O20041025000442 |
| Mailing Address | Practice Location Address |
|---|---|
| Mark S Dwyer, MD Po Box 5074, Sioux Falls, SD 57117-5074 Ph: () - | Mark S Dwyer, MD 1611 Anne St Nw, Bemidji, MN 56601-5114 Ph: (218) 333-2020 |
Shelby Marie Potkin, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 1611 Anne St Nw, Bemidji, MN 56601 Phone: 218-333-2020 | |
Ashley Marie Lundin, M.D. Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 1611 Anne St Nw, Bemidji, MN 56601 Phone: 218-333-2020 | |
Mark A Shanfeld, M.D. Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 1611 Anne St Nw, Bemidji, MN 56601 Phone: 218-333-2020 |