Organization
ANTHONY MARTIN MDMS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY MARTIN MD (OWNER/PRESIDENT)
(734) 792-0441
Entity
Organization
Contact information
Practice address
16001 W 9 MILE RD, PROVIDENCE HOSPITAL, SOUTHFIELD, MI 48075-4818
(313) 971-3698
Mailing address
10096 HART AVE, HUNTINGTON WOODS, MI 48070-1126
(248) 655-0337
(248) 655-0339
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301061359
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4616478
—
MI
01
—
DE6518
PALMETTO GBA RAILROAD MR
—
Enumeration date
07/26/2006
Last updated
02/29/2016
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