Individual
STEVE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5575 CONNER ST STE A, DETROIT, MI 48213-6400
(888) 688-4311
(888) 681-4311
Mailing address
5575 CONNER ST STE 201, DETROIT, MI 48213-6401
(888) 688-4311
(888) 688-4311
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
23D2179512
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23D2179512
BLUE CROSS
MI
05
—
23D2179512
—
MI
Enumeration date
04/04/2020
Last updated
04/04/2020
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