| Mark D Antenucci Dpm Pc | |
|
313 W Country Club Rd, Suite 7, Roswell, NM 88201-5804 | |
| (575) 624-2398 | |
| (575) 624-0655 |
| Full Name | Mark D Antenucci Dpm Pc |
|---|---|
| Type | Facility |
| Speciality | Podiatrist |
| Location | 313 W Country Club Rd, Roswell, New Mexico |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548624372 | NPI | - | NPPES |
| 55657 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | (* (Not Available)) | Primary |
| Provider Name | Mark D Antenucci |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1760490759 PECOS PAC ID: 0446254346 Enrollment ID: I20061010000738 |
| Mailing Address | Practice Location Address |
|---|---|
| Mark D Antenucci Dpm Pc 313 W Country Club Rd, Suite 7, Roswell, NM 88201-5804 Ph: (575) 624-2398 | Mark D Antenucci Dpm Pc 313 W Country Club Rd, Suite 7, Roswell, NM 88201-5804 Ph: (575) 624-2398 |
Jeffrey Ash, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 300 W Country Club Rd Ste 130, Roswell, NM 88201 Phone: 575-625-2669 Fax: 575-625-1296 | |
Dr. Mark David Antenucci, D.P.M Podiatrist Medicare: May Accept Medicare Assignments Practice Location: 313 West Country Club Rd., Ste. 7, Roswell, NM 88201 Phone: 575-624-2398 Fax: 575-624-0655 |