Individual
DR. MARK DAVID ANTENUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M
Contact information
Practice address
313 WEST COUNTRY CLUB RD., STE. 7, ROSWELL, NM 88201
(575) 624-2398
(575) 624-0655
Mailing address
313 WEST COUNTRY CLUB RD., STE. 7, ROSWELL, NM 88201
(575) 624-2398
(575) 624-0655
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
184
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
55657
—
NM
Enumeration date
08/04/2006
Last updated
06/24/2009
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