DR. Mark T Destache, MD

NPI #1023129483 in Saint Paul, Minnesota

Provider Information

NPI Number: 1023129483
Entity Type: Individual
Name: DR. Mark T Destache, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Anesthesiology
Credential: MD
Enumeration Date: Aug 31, 2006
Last Updated: Aug 2, 2022

Practice Location

Address: 333 SMITH AVE N
City: Saint Paul
State: Minnesota
ZIP Code: 55102-2344
Phone: (651) 735-0501

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Anesthesiology	207L00000X	Primary

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