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Individual

DR. MARK HNATIUK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
26850 PROVIDENCE PARKWAY, SUITE 205, NOVI, MI 48374-1252
(248) 465-5314
(248) 465-5301
Mailing address
26850 PROVIDENCE PARKWAY, SUITE 205, NOVI, MI 48374-1252
(248) 465-5314
(248) 465-5301

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
4301074049
MI
207YS0123X
Facial Plastic Surgery Physician
430107409
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
389063649-00
BWC
OH
Enumeration date
12/23/2005
Last updated
06/03/2010
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