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Individual

MARK VAN ANTWERP

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2400 S AVENUE A, YUMA, AZ 85364-7127
(602) 273-6770
(602) 889-0489
Mailing address
PO BOX 29211, PHOENIX, AZ 85038-9211
(602) 273-6770
(602) 889-0489

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
29376
AZ

Other

Enumeration date
10/20/2005
Last updated
07/08/2007
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