Individual
ANTHONY MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
24411 SHERMAN ST, OAK PARK, MI 48237-1850
(124) 655-0337
(248) 655-0339
Mailing address
460 S GULLEY RD, DEARBORN HEIGHTS, MI 48125-1005
(313) 792-0441
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301061359
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019509
MIDWEST HEALTH PLAN
MI
01
—
1108249942
BCBSM
MI
01
—
133021
TRINITY HEALTH PLANS
MI
05
—
4616478
—
MI
01
—
60252
OMNICARE
MI
01
—
DE6518
PALMETTO GBA RAILROAD MR
MI
01
—
NC023552
MCARE
MI
Enumeration date
06/22/2006
Last updated
03/07/2023
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