Individual
DR. SAMUEL I MARTISIUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
13355 E 10 MILE RD, WARREN, MI 48089-2048
(586) 759-7690
Mailing address
13355 E 10 MILE RD, WARREN, MI 48089-2048
(586) 759-7690
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5101018393
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5101018393
—
MI
Enumeration date
07/21/2009
Last updated
08/25/2009
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