MARK A. MASTELLOTTO NPI 1972211134

NPI Information

  • NPI: 1972211134
  • Provider Name: MARK A. MASTELLOTTO
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • Address: 760 RIVERSIDE AVE
    ADRIAN, MI
    ZIP 49221
  • Phone: (517) 263-0338

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NPI Details

MARK A. MASTELLOTTO is a clinic center in Adrian, MI. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). MARK A. MASTELLOTTO NPI is 1972211134. The provider is registered as an organization entity type.

The provider's business location address is:

760 RIVERSIDE AVE
ADRIAN, MI
ZIP 49221-445
Phone: (517) 263-0338
Fax: (517) 263-1138

The provider's authorized official is Mark Arthur Mastellotto .
The authorized official title is Owner and has the following contact phone number (517) 263-0338.

The enumeration date for this NPI number is 11/7/2022 and was last updated on 11/7/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QD0000XClinic/CenterDentalNo
2261Q00000XClinic/CenterYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11013077601OTHERALL INSURANCE
21013077601OTHERMICHIGANALL INSURANCE
31013077601MEDICAIDMICHIGAN
41013077601OTHERMICHIGANDENTAL

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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