Active NPI
Mark P Koniuch, MD
- Orthopaedic Hand Surgery Physician
- Troy, MI
National Provider Identifier
1902888233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Hand Surgery Physician
- License
- 4301040857
- Practice address
- 44199 Dequindre Rd
Ste 250
Troy, MI 48085 - Phone
- (248) 879-8441
- Fax
- (248) 879-6841
- NPI assigned
- Nov 14, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Orthopaedic Hand Surgery Physician | 207XS0106X | 4301040857 | MI | Primary |
Addresses
Primary practice location
44199 Dequindre Rd
Ste 250
Troy, MI 48085
Mailing address
44199 Dequindre Rd
Ste 250
Troy, MI 48085
Phone (248) 879-8441
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 383300551 | 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 |
|---|---|---|---|
| 4301040857 | MI | MD | Orthopaedic Hand Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373587200000",
"number": "1902888233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44199 DEQUINDRE RD",
"address_2": "STE 250",
"city": "TROY",
"state": "MI",
"postal_code": "48085",
"telephone_number": "248-879-8441",
"fax_number": "248-879-6841"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44199 DEQUINDRE RD",
"address_2": "STE 250",
"city": "TROY",
"state": "MI",
"postal_code": "48085",
"telephone_number": "248-879-8441",
"fax_number": "248-879-6841"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KONIUCH",
"first_name": "MARK",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-14",
"last_updated": "2013-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "207XS0106X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Hand Surgery",
"state": "MI",
"license": "4301040857",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "383300551",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Troy, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.