NPI 1023129483

Mark T Destache, MD

Practitioner Anesthesiology Physician Saint Paul, MN

Practice location

Address: 333 Smith Ave N, Saint Paul, MN 55102-2344
Phone: (651) 735-0501
Fax: (651) 735-1870
Mailing address: 8681 Eagle Point Blvd, Lake Elmo, MN 55042-8628

Registered specialties (2)

Anesthesiology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207L00000X Licence 34185 (MN)

Other Anesthesiology providers in Minnesota →

Anesthesiology Physician

Allopathic & Osteopathic Physicians Taxonomy 207L00000X Licence 036159952 (IL)

Registry record

NPI: 1023129483
Entity type: Individual
Sex (as registered): Male
NPI issued: 31 Aug 2006
Record last updated: 2 Aug 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.