Individual
MARC A ANTONCHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1211 DUBLIN RD, COLUMBUS, OH 43215-1091
(614) 486-5200
(614) 486-9665
Mailing address
1211 DUBLIN RD, COLUMBUS, OH 43215-1026
(614) 486-5200
(614) 486-9665
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
35089230
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2954156
—
OH
01
—
31-1425166
FEDERAL TAX ID
—
01
—
9279991
GROUP MEDICARE
OH
01
—
PO0762429
RAILROAD MEDICARE
OH
Enumeration date
10/24/2007
Last updated
08/26/2025
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