Active NPI
Mark Wilfred Puls, M.D.
- Surgery Physician
- Alpena, MI
National Provider Identifier
1164599635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 4301403324
- Practice address
- 311 Long Rapids PLZ
Alpena, MI 49707-1375 - Phone
- (989) 354-5717
- Fax
- (989) 356-6526
- NPI assigned
- Nov 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 4301403324 | MI | Primary |
Addresses
Primary practice location
311 Long Rapids PLZ
Alpena, MI 49707-1375
Mailing address
311 Long Rapids PLZ
PO Box 535
Alpena, MI 49707-1375
Phone (989) 354-5717
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3396665 | Medicaid | MI | |
| 0041029 | Other | MI | BLUE CROSS PIN |
| 3070608 | Medicaid | MI | |
| 3396683 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301403324 | MI | MD | Surgery Physician |
Interoperability endpoints
- mpuls59751@mymichiganhealth.midirect.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193184000000",
"number": "1164599635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "311 LONG RAPIDS PLZ",
"address_2": "PO BOX 535",
"city": "ALPENA",
"state": "MI",
"postal_code": "497071375",
"telephone_number": "989-354-5717",
"fax_number": "989-356-6526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 LONG RAPIDS PLZ",
"city": "ALPENA",
"state": "MI",
"postal_code": "497071375",
"telephone_number": "989-354-5717",
"fax_number": "989-356-6526"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PULS",
"first_name": "MARK",
"middle_name": "WILFRED",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-29",
"last_updated": "2007-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MI",
"license": "4301403324",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3396665",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PIN",
"identifier": "0041029",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3070608",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3396683",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Alpena, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.