DR. MARK DAVID ANTENUCCI (NPI# 1760490759) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760490759 |
| Entity Type | Individual |
| Full Name | DR. MARK DAVID ANTENUCCI |
| Credential | D.P.M |
| Practice Address |
313 West Country Club Rd. Ste. 7 Roswell NM 88201 |
| Practice Telephone | 5756242398 |
| Practice Fax Number | 5756240655 |
| Mailing Telephone | 5756242398 |
| Mailing Fax Number | 5756240655 |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2009-06-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 184 | NM | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 55657 | 05 |
| Street Address |
313 WEST COUNTRY CLUB RD. STE. 7 |
| City | ROSWELL |
| State | NM |
| Zip Code | 88201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902310022 | Corey A Carter | Specialist/Technologist, Other | 117 E 19th Street, Roswell, NM 88201 | 2017-11-28 |
| 1326598541 | Dove Medical Corporation | Family Medicine | 110 East 3rd Street, Roswell, NM 88201 | 2016-10-12 |
| 1841748381 | Anali Velez | Registered Nurse | 300 N Kentucky, Roswell, NM 88201 | 2016-09-13 |
| 1831647379 | Rebecca Palomino | Registered Nurse | 800 Marion Richards Rd, Roswell, NM 88201 | 2016-09-13 |
| 1215300926 | Heart Path Oriental Medicine | Clinic/Center | 810 N Union, Roswell, NM 88201 | 2015-11-03 |
| 1538564745 | Lacey Scott | Pharmacist | 1835 N. Main, Roswell, NM 88201 | 2014-10-30 |
| 1962815852 | Marium Khan | Internal Medicine | 400 Military Heights Place, Roswell, NM 88201 | 2014-06-09 |
| 1316288913 | Anaya Counseling | Community/Behavioral Health | 613 W 2nd St Ste 4, Roswell, NM 88201 | 2013-03-06 |
| 1205185386 | Rosarita Brady | Occupational Therapist | 300 N. Kentucky, Roswell, NM 88201 | 2012-09-05 |
| 1922360049 | Ashley Spinhirne Thompson | Speech-Language Pathologist | 304 N. Richardson, Roswell, NM 88201 | 2012-06-14 |
| Find all providers in zip 88201 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326153339 | Michael J King | Podiatrist | 1350 Upper Hembree Rd., Suite 100, Roswell, GA 30076-4651 | 2006-08-20 |
| 1558327809 | Mitchell P. Hilsen | Podiatrist | 1350 Upper Hembree Rd, Suite 100, Roswell, GA 30076-0927 | 2006-04-25 |
| 1972584498 | Joel E Schancupp | Podiatrist | 1030 Woodstock Rd, Ste 3106, Roswell, GA 30075-8271 | 2005-11-10 |
| 1548624372 | Mark D Antenucci Dpm PC | Podiatrist | 313 W Country Club Rd, Suite 7, Roswell, NM 88201-5804 | 2016-04-07 |
| 1417056847 | Dean P Kostakos | Podiatrist | 1380 Upper Hembree Rd, Roswell, GA 30076-1146 | 2006-09-22 |
| 1235149196 | Jeffrey Ash | Podiatrist | 300 W Country Club Rd, Suite #130, Roswell, NM 88201-5202 | 2006-08-09 |
| 1649294067 | Village Podiatry Group, LLC. | Podiatrist | 1350 Upper Hembree Rd, Suite 100, Roswell, GA 30076-4651 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710360037 | Yvonne Miriaku Muojieje | Podiatrist | 4500 N Sonoma Ranch Blvd, Las Cruces, NM 88011-7334 | 2015-07-06 |
| 1437536786 | Daniel L. Peterson | Podiatrist | 4401 Coors Blvd Sw Ste A, Albuquerque, NM 87121-6460 | 2015-05-06 |
| 1396146957 | Stephanie Gonzalez | Podiatrist | 4151 Camino Coyote Ste B, Las Cruces, NM 88011-7096 | 2014-09-12 |
| 1699060202 | Juan Tabo Foot Health Center, PC | Podiatrist | 1925 Juan Tabo Blvd Ne, Suite D, Albuquerque, NM 87112-3366 | 2011-06-10 |
| 1043518335 | Center for Foot Care, Ltd | Podiatrist | 3064 Plaza Blanca, Santa Fe, NM 87507 | 2011-03-10 |
| 1891954657 | Theodore L Varoz Dpm | Podiatrist | 1204 Candelaria Rd Nw, Albuquerque, NM 87107-2766 | 2008-06-06 |
| 1710175872 | J Garey Ritchie | Podiatrist | 904 E 20th St Ste C, Farmington, NM 87401-4281 | 2007-10-13 |
| 1811197346 | Attlee Becenti Benally | Podiatrist | 1 Sagebrush Rd., Isleta Pueblo Diabetic Clinic, Isleta, NM 87022 | 2007-07-23 |
| 1922219203 | Albuquerque Associated Podiatrists | Podiatrist | 121 Sycamore St Ne, Albuquerque, NM 87106-4622 | 2007-05-25 |
| 1760535926 | Charles Jackson | Podiatrist | 820 N Dalmont St, Hobbs, NM 88240-5214 | 2007-01-19 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. MARK DAVID ANTENUCCI.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.