Provider Demographics
NPI:1295719607
Name:MANN, ORRIN (MD)
Entity type:Individual
Prefix:
First Name:ORRIN
Middle Name:
Last Name:MANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 FRANCE AVE S STE 230
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-1907
Mailing Address - Country:US
Mailing Address - Phone:952-908-2700
Mailing Address - Fax:952-908-2701
Practice Address - Street 1:6700 FRANCE AVE S STE 230
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435
Practice Address - Country:US
Practice Address - Phone:952-908-2700
Practice Address - Fax:952-908-2701
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN359502083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN829760600Medicaid
MNP00005185Medicare ID - Type UnspecifiedRAIL ROAD MEDICARE