Individual
ANTHONY WENDELL MARCUKAITIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1585 THIRD ST, FORT POLK, LA 71459-5102
(337) 531-3517
Mailing address
8350 JOY RD, KALEVA, MI 49645-9686
(517) 974-3236
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704215056
MI
Other
Enumeration date
09/05/2006
Last updated
11/02/2021
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