# MARK HNATIUK MD PLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CRANIOFACIAL INSTITUTE OF MICHIGAN
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619304490
- **Authorized official:** DR. MARK HNATIUK M.D. (M.D./OWNER)
- **Authorized official phone:** (734) 812-7415

## Contact information

- **Practice address:** 15120 MICHIGAN AVE, DEARBORN, MI 48126-2916
- **Practice address phone:** (734) 812-7415
- **Practice address fax:** (734) 212-2125
- **Mailing address:** 15120 MICHIGAN AVE, DEARBORN, MI 48126-2916
- **Mailing address phone:** (734) 812-7415
- **Mailing address fax:** (734) 212-2125

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YS0123X | Facial Plastic Surgery Physician | — | NULL | Yes |
| 207YS0123X | Facial Plastic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/11/2013
- **Last updated:** 10/14/2013