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Individual

ANTONIO F MENDIOLA JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1827 GREENWOOD RD, PRESCOTT, MI 48756-8626
(989) 873-6200
(989) 873-5563
Mailing address
1827 GREENWOOD RD, PRESCOTT, MI 48756-8626
(989) 873-6200
(989) 873-5563

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
046416
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3038010
MI
Enumeration date
07/12/2005
Last updated
01/23/2017
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