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Individual

DR. MARK DOUGLAS ENSBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5091 WILLOUGHBY RD, HOLT, MI 48842-1054
(517) 694-2144
(517) 694-6570
Mailing address
804 SERVICE RD STE A109B, EAST LANSING, MI 48824-7015

Taxonomy

Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
4301048610
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2655771
MI
Enumeration date
07/03/2006
Last updated
06/12/2019
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