Mark C. Antonishen, M.D., P.L.L.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301046169 Issued in MI

Legal business name

MARK C. ANTONISHEN, M.D., P.L.L.C.

Practice address

405 N Division Rd
Ste 3
Petoskey, MI 49770-9045

Phone

(231) 487-6030

Fax

(231) 487-6010

NPI assigned

Oct 16, 2007

Organization subpart

No

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

Authorized official

Name

Mark C Antonishen, M.D.

Title

President

Phone

(231) 487-6030

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192492800000",
    "number": "1861681819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 N DIVISION RD",
            "address_2": "STE 3",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497709045",
            "telephone_number": "231-487-6030",
            "fax_number": "231-487-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 N DIVISION RD",
            "address_2": "STE 3",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497709045",
            "telephone_number": "231-487-6030",
            "fax_number": "231-487-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK C. ANTONISHEN, M.D., P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-16",
        "last_updated": "2007-10-16",
        "status": "A",
        "authorized_official_last_name": "ANTONISHEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "231-487-6030",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301046169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Salvatore A Manno, PA-C
• Elizabeth Marie Mansfield, OTRL
• Richard W Mansfield, D.O.
• Margaret a Orr MD PLLC
• Emmye Ann Marihugh, L.M.T.
• Mark R McMurray MD PC
• Mark R McMurray MD PC
• Kevin M Markham, M.D.
• James William Marshall III, M.A.
• Ronald Clemens Marshall, PHD

• Internal Medicine Physician in Petoskey, MI
• Providers in Petoskey, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.

Verify at the official NPI Registry.