Fantauzzi, Mark R.
Fantauzzi, Mark R. is an individual health care provider with primary practice located at 1219 Findlay St , Portsmouth OH 45662-3449. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Fantauzzi, Mark R. can be contacted via phone (816) 809-1724.Contact Information
Primary practice address
1219 Findlay St
Portsmouth OH 45662-3449
Phone: (816) 809-1724
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 110525 | Missouri |
Profile Details
| NPI number | 1831179084 |
|---|---|
| LBN Legal business name | Fantauzzi, Mark R. |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 21st, 2006 |
| Last updated | May 11th, 2010 - about 14 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 | 1831179084 | NPPES |
| Missouri | MEDICAID | 249732001 |
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