Mark L. Midenberg, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

AL116 Issued in AL

Practice address

115 Queensbury Dr SW
Huntsville, AL 35802-1501

Phone

(256) 880-0222

Fax

(256) 880-3404

NPI assigned

Sep 13, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284595200000",
    "number": "1497850655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 QUEENSBURY DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358021501",
            "telephone_number": "256-880-0222",
            "fax_number": "256-880-3404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 QUEENSBURY DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358021501",
            "telephone_number": "256-880-0222",
            "fax_number": "256-880-3404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDENBERG",
        "first_name": "MARK",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2010-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AL",
            "license": "AL116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER #",
            "identifier": "72216",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amaya Ashanti Middlebrooks
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• Randle Thomas Middleton, M.D.
• Midtown Dental LLC
• Lauren Miele, DMD
• Chankira Mike, PHARMD
• Kilee Mikell, LICSW
• Nancy Scott Mikolaschek, LPC

• Foot & Ankle Surgery Podiatrist in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Foot & Ankle Surgery Podiatrist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.