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Individual

DR. MARK S. CANTIERI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
3555 PARK PL W, STE 200, MISHAWAKA, IN 46545-3513
(574) 271-8646
(574) 271-8624
Mailing address
12497 DRAGOON TRL, MISHAWAKA, IN 46544-9449
(574) 633-4190

Taxonomy

Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
IA01993
IA
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
IN2001185A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200011350A
IN
Enumeration date
06/10/2005
Last updated
10/18/2007
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