Mark C. Antonishen, M.d., P.l.l.c.

NPI #1861681819 in Petoskey, Michigan

Provider Information

NPI Number: 1861681819
Entity Type: Organization
Organization Name: Mark C. Antonishen, M.d., P.l.l.c.
Primary Specialty: Internal Medicine
Enumeration Date: Oct 16, 2007
Last Updated: Oct 16, 2007

Practice Location

Address: 405 N DIVISION RD
Address 2: STE 3
City: Petoskey
State: Michigan
ZIP Code: 49770-9045
Phone: (231) 487-6030

Authorized Official

Name: MARK C ANTONISHEN, M.D.
Title: PRESIDENT
Phone: (231) 487-6030

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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