Mark S Mellstrom, MD, PA
NPI 1639340409ActiveOrganization· Family Medicine· Lakeville, MN
Family Medicine in Lakeville, Minnesota, registered in NPPES in March 2008. The authorized official on file is Mark Stanley Mellstrom, M.D, President.
Overview
| NPI | 1639340409 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 19, 2008 |
| Last updated in NPPES | Apr 23, 2008 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | 27926 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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