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Individual
MR. MARK DOUGLAS CETTIE
Active
Individual
MR. MARK DOUGLAS CETTIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
TX0974
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TX0974
TX STATE LIC
—
Enumeration date
09/06/2005
Last updated
08/14/2012
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