Provider Demographics
NPI:1073515805
Name:MARTONE, MARK J (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:J
Last Name:MARTONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1200 6TH AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-2735
Mailing Address - Country:US
Mailing Address - Phone:320-252-5131
Mailing Address - Fax:320-240-2118
Practice Address - Street 1:1200 6TH AVE N
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-2735
Practice Address - Country:US
Practice Address - Phone:320-252-5131
Practice Address - Fax:320-240-2118
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN38248207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
600873OtherARAZ GROUP/AMERICA'S PPO
9D412MAOtherBCBS
CQ2388OtherRR MEDICARE
HP25482OtherHEALTH PARTNERS
080076644OtherRR MEDICARE
MN641314500Medicaid
2114006OtherFIRST HEALTH PLAN
2501025OtherMEDICA HEALTH PLANS
641314500OtherMEDICAL ASSITANCE
110908OtherU-CARE
1009667OtherPREFERRED ONE
2114006OtherFIRST HEALTH PLAN
2501025OtherMEDICA HEALTH PLANS