Individual
DR. MARK ANTHONY CHESEBRO JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
11109 PARKVIEW PLAZA DR, FORT WAYNE, IN 46845-1701
(260) 482-4440
Mailing address
608 UNION CHAPEL RD, FORT WAYNE, IN 46845-9357
(269) 982-4941
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
02008912A
IN
207P00000X
Emergency Medicine Physician
5151016213
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
MI
Other
Enumeration date
04/20/2023
Last updated
06/24/2026
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