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General NPI Number Information
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NPI Number | 1255331138
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Entity Type | Individual
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Provider Name | MARK P ANSTADT M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/21/2005
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 30 E APPLE ST STE 4256
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City | DAYTON
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State | OH
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Zip | 45409-2939
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Country | US
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Telephone | 937-208-6060
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Fax | 937-208-6061
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Provider Business Mailing Address
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Address Line | P.O. BOX 407
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City | DAYTON
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State | OH
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Zip | 45409
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Country | US
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Telephone | 937-208-6060
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Fax | 937-208-6061
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 35-056443 A
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 4301512884
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License Number State | MI
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