Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mark Kenneth Widstrom

Individual provider Obstetrics & Gynecology Physician · NPI 1689692758

Mark Kenneth Widstrom is an Obstetrics/Gynecology in Duluth, Minnesota. Graduated from University of Minnesota Medical School in 1993, 33 years ago. Practices with Polinsky Medical Rehabilitation Center, a 380-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
33
Trained at
University of Minnesota Medical School
Licensed in
MN
In the registry since
2006

Practice location Address checks out

400 E 3rd St
Duluth, MN 55805-1951
Phone: (218) 786-8364
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence 45497 (MN)

Record details

NPI number1689692758
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 17, 2006
Last updated in NPPESMay 9, 2011
Mailing address400 E 3rd St, Duluth, MN 55805-1951

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOBSTETRICS/GYNECOLOGY
Medical schoolUNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduated 1993 (33 years in practice)
Group practice Polinsky Medical Rehabilitation Center — 380 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

Other providers in Duluth