Organization
MARK D ANTENUCCI DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CRISTINA ANTENUCCI (OFFICE MANAGER)
(575) 624-2398
Entity
Organization
Contact information
Practice address
313 W COUNTRY CLUB RD, SUITE 7, ROSWELL, NM 88201-5804
(575) 624-2398
(575) 624-0655
Mailing address
313 W COUNTRY CLUB RD, SUITE 7, ROSWELL, NM 88201-5804
(575) 624-2398
(575) 624-0655
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
55657
—
NM
Enumeration date
04/07/2016
Last updated
04/07/2016
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