Individual
MARK ANTOS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1501 MIDDLEFORD RD, SEAFORD, DE 19973-3615
(302) 629-4255
(302) 629-5777
Mailing address
1501 MIDDLEFORD RD, SEAFORD, DE 19973-3615
(302) 629-4255
(302) 629-5777
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
C10003337
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000102501
—
DE
Enumeration date
03/20/2006
Last updated
07/08/2007
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