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
Phone: (517) 694-2144
Fax: (517) 694-6570
Website:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1912936527 | NPPES |
Michigan | MEDICAID | 2655771 |
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