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Contact Information

MARK D ANTENUCCI DPM PC
313 W COUNTRY CLUB RD
SUITE 7
ROSWELL, NM88201-5804
 Phone: 575-624-2398
 Fax: 575-624-0655
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for MARK D ANTENUCCI DPM PC

NPI # 1548624372
LBN Legal business name MARK D ANTENUCCI DPM PC
Authorized official CRISTINA ANTENUCCI - (OFFICE MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 04/07/2016
Last updated 04/07/2016 - About 10 years ago
Identifiers
NM Medicaid 55657
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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