Individual
REX ANTINOZZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4100 PARK FOREST DR, SUITE 208, TRAVERSE CITY, MI 49684-7331
(231) 935-5710
(231) 935-9045
Mailing address
4100 PARK FOREST DR, SUITE 208, TRAVERSE CITY, MI 49684-7331
(231) 935-5710
(231) 935-9045
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
RA049843
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4343067
—
MI
01
—
OB81010
BCBSM
MI
Enumeration date
12/13/2006
Last updated
08/29/2008
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