National Provider Identifier Database

MARK D ANTENUCCI, D.P.M – NPI #1760490759
Podiatrist

A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.


Contact Information

MARK D ANTENUCCI, D.P.M
313 WEST COUNTRY CLUB RD.
STE. 7
ROSWELL, NM88201
Phone: 575-624-2398
Fax: 575-624-0655
Website:
Specialty Taxonomy Code
* Podiatrist 213E00000X

* Indicates primary specialty

NPI Profile & details for MARK D ANTENUCCI

NPI Number 1760490759
Credentials D.P.M
Entity Individual
Enumeration date 08/04/2006
Last updated 06/24/2009 - About 17 years ago
Sole proprietor1 No
Identifiers
  • NM License #: 184
  • NM Medicaid: 55657
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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