Individual provider · NPI-1

Mark S Dwyer, MD

Ophthalmology · Bemidji, MN

NPI number1962420505
StatusActive
Last updated in NPPESOct 19, 2023

Details

NPI
1962420505
Entity type
Individual (NPI-1)
Name
Mark S Dwyer
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Jul 18, 2006
Certification date
Oct 19, 2023
Last updated
Oct 19, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207W00000X Ophthalmology34382MNYes

Practice location

1611 Anne St Nw
Bemidji, MN 56601-5114

Phone 218-333-2020 · Fax 218-333-2019

Mailing address

Po Box 5074
Sioux Falls, SD 57117-5074

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