DR. MARK DOUGLAS ENSBERG (NPI# 1912936527) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912936527 |
| Entity Type | Individual |
| Full Name | DR. MARK DOUGLAS ENSBERG |
| Credential | MD |
| Practice Address |
5091 Willoughby Rd Holt MI 48842-1054 |
| Mailing Address |
804 Service Rd Ste A109b East Lansing MI 48824-7015 |
| Practice Telephone | 5176942144 |
| Practice Fax Number | 5176946570 |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2019-06-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
4301048610 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 2655771 | 05 |
| Street Address |
5091 WILLOUGHBY RD |
| City | HOLT |
| State | MI |
| Zip Code | 48842-1054 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245865328 | Msu Health Care Inc | Family Medicine | 5091 Willoughby Rd, Holt, MI 48842-1054 | 2020-03-09 |
| 1669031662 | Lisa Bower | Speech-Language Pathologist | 5091 Willoughby Rd, Holt, MI 48842-1054 | 2019-06-12 |
| 1992362883 | Kacey Ann Morey | Physical Medicine & Rehabilitation | 5091 Willoughby Rd, Holt, MI 48842-1054 | 2019-05-26 |
| 1407413362 | Epiphanie Byiringiro Usengimana | Occupational Therapy Assistant | 5091 Willoughby Rd, Holt, MI 48842-1054 | 2019-05-24 |
| 1457918492 | Gayle Lynne Greenman | Physical Therapy Assistant | 5091 Willoughby Rd, Holt, MI 48842-1054 | 2019-05-24 |
| 1831756857 | Janice May Heeney | Physical Therapy Assistant | 5091 Willoughby Rd, Holt, MI 48842-1054 | 2019-05-24 |
| 1801453824 | Jason Daniel Morgan | Physical Therapy Assistant | 5091 Willoughby Rd, Holt, MI 48842-1054 | 2019-05-24 |
| 1871150821 | Stacey Renee Klokkert | Occupational Therapy Assistant | 5091 Willoughby Rd, Holt, MI 48842-1054 | 2019-05-24 |
| 1124581640 | Kayla Lynn Schunk | Physical Therapy Assistant | 5091 Willoughby Rd, Holt, MI 48842-1054 | 2019-04-11 |
| 1730664467 | Meghan K Wise | Dietitian, Registered | 5091 Willoughby Rd, Holt, MI 48842-1054 | 2018-09-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730708538 | Dylan Voris | Psychologist | 4523 E Willoughby Rd., Holt, MI 48842 | 2020-04-11 |
| 1013458835 | Allison Ann Pingston | Specialist/Technologist | 23747 Rolling Ridge Ln., Holt, MI 48842 | 2017-03-13 |
| 1528417706 | Marybeth Timotiwu | Technician, Other | 3940 Acorn Cir, Holt, MI 48842 | 2016-06-08 |
| 1831593623 | Mary Nelson | Rehabilitation Practitioner | 3860 Wachtel Drive, Holt, MI 48842 | 2014-10-22 |
| 1598869703 | Nicole Elizabeth Durnin | Pharmacist | 2018 N. Cedar Street, Suite A, Holt, MI 48842 | 2006-09-08 |
| 1225130560 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 2240 Cedar St, Holt, MI 48842 | 2006-09-05 |
| 1073622973 | Marilyn Viera | Family Medicine | 2380 Cedat St, Holt, MI 48842 | 2006-08-30 |
| 1942228291 | Stephen N. Glover | Pharmacist | 2390 N. Cedar St., Holt, MI 48842 | 2006-07-17 |
| 1740244169 | Pamela Thompson | Family Medicine | 4221 Charlar Dr, Holt, MI 48842 | 2006-04-13 |
| 1407847387 | Amy Lynn Cousineau | Optometrist | 2040 Aurelius Rd Ste 20, Holt, MI 48842 | 2005-10-31 |
| Find all providers in zip 48842 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801371315 | Matrix Medical Pllc | Internal Medicine | 52611 Blueridge Dr, Shelby Twp, MI 48316-2977 | 2018-10-01 |
| 1407364821 | Chesaning Comfort Care | Internal Medicine | 1800 W Brady Rd, Chesaning, MI 48616 | 2018-01-19 |
| 1992252191 | Vitality Home Health Services,inc. | Internal Medicine | 917 W Milham Ave, Portage, MI 49024-1248 | 2016-09-06 |
| 1427419662 | Shoaib A Rasheed | Internal Medicine | 250 Mcdougall St, Detroit, MI 48207-4291 | 2016-03-16 |
| 1710226477 | Nancy Couch | Internal Medicine | 791 Bradburn Ct, Northville, MI 48167-1027 | 2013-01-31 |
| 1639425879 | Anhkiet L Tran | Internal Medicine | 29736 Orion Ct, Farmington Hills, MI 48334-4114 | 2012-07-25 |
| 1700152014 | Nicholas Joseph | Internal Medicine | 24463 W 10 Mile Rd, Pace Southeast Michigan, Southfield, MI 48033-2931 | 2012-03-30 |
| 1689949034 | Drs Housecalls PC | Internal Medicine | 298 S. Old Woodward, Birminham, MI 48009 | 2012-03-19 |
| 1699055269 | Mobilized Docs of Michigan LLC | Internal Medicine | 23943 Industrial Park Dr, Farmington Hills, MI 48335-2862 | 2011-08-26 |
| 1780986018 | Spectrum Health Primary Care Partners | Internal Medicine | 727 Apple Ave, Holland, MI 49423-5405 | 2010-11-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.