Individual provider · NPI-1

Mark H. Brakke, MD

Family Medicine · Coon Rapids, MN

NPI number1013986637
StatusActive
Last updated in NPPESJul 13, 2026

Details

NPI
1013986637
Entity type
Individual (NPI-1)
Name
Mark H. Brakke
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Mar 16, 2006
Last updated
Jul 13, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine21080MNYes

Practice location

9055 Springbrook Dr Nw
Coon Rapids, MN 55433-5841

Phone 763-780-9155

Mailing address

Po Box 43
Mr 10809
Minneapolis, MN 55440-0043

Phone 612-262-4813 · Fax 612-262-4194

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