Ensberg, Mark Douglas

Ensberg, Mark Douglas is an individual health care provider with primary practice located at 5091 Willoughby Rd , Holt MI 48842-1054. He recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Medicine, which is considered as his primary health care specialty. Ensberg, Mark Douglas can be contacted via phone (517) 694-2144.

Contact Information

Primary practice address
5091 Willoughby Rd Holt MI 48842-1054
Fax: (517) 694-6570
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 4301048610 Michigan

Profile Details

NPI number 1912936527
LBN Legal business name Ensberg, Mark Douglas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2006
Last updated Jun 12th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912936527 NPPES
Michigan MEDICAID 2655771

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