Individual
MARK D CANTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1835 ODDIE BLVD, SPARKS, NV 89431-3559
(775) 982-5140
(775) 982-5141
Mailing address
780 KUENZLI ST, RENO, NV 89502-0845
(775) 982-5262
(775) 982-5496
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036-082935
IL
207Q00000X
Family Medicine Physician
Primary
15475
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036082935
—
IL
01
—
833230
MEDICARE GROUP # FOR PONTIAC
—
Enumeration date
11/13/2006
Last updated
01/27/2016
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