| Mark C. Antonishen, M.D., P.L.L.C. | |
|
405 N Division Rd Ste 3 Petoskey MI 49770-9045 | |
| (231) 487-6030 | |
| (231) 487-6010 |
| Full Name | Mark C. Antonishen, M.D., P.L.L.C. |
|---|---|
| Speciality | Internal Medicine |
| Location | 405 N Division Rd, Petoskey, Michigan |
| Authorized Official Name and Position | Mark C Antonishen (PRESIDENT) |
| Authorized Official Contact | 2314876030 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark C. Antonishen, M.D., P.L.L.C. 405 N Division Rd Ste 3 Petoskey MI 49770-9045 Ph: (231) 487-6030 | Mark C. Antonishen, M.D., P.L.L.C. 405 N Division Rd Ste 3 Petoskey MI 49770-9045 Ph: (231) 487-6030 |
| NPI Number | 1861681819 |
|---|---|
| Provider Enumeration Date | 10/16/2007 |
| Last Update Date | 10/16/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861681819 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4301046169 (Michigan) | Primary |
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