Audberto Cesar Antonini, M.D.

Individual provider Active NPI Internal Medicine Physician · Portage, MI

NPI 1457548729 · NPPES record last updated Oct 1, 2007

Key facts

NPI
1457548729
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
4301062716 (MI)
Practice address
7901 Angling Rd
Portage, MI 49024-0714
Phone
(269) 226-8253
Fax
(269) 226-8190
NPI assigned
Oct 1, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
HHS exclusion list flag
The National Provider Directory flags this NPI as appearing on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301062716 MI Yes

Addresses

Primary practice location

7901 Angling Rd
Portage, MI 49024-0714

Mailing address

203 Concord Dr
Canton, MI 48188-5284
Phone (734) 398-5412

Other providers in Portage, MI

All providers in Portage, MI · Internal Medicine Physician in Michigan

Sources for this page

Verify at the official NPI Registry.