Organization
ANIS & MARTIN INTERNAL MEDICINE ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL MARTIN MD (MD)
(860) 644-1523
Entity
Organization
Contact information
Practice address
1504 SULLIVAN AVE, SOUTH WINDSOR, CT 06074-2711
(860) 644-1523
(860) 648-9468
Mailing address
PO BOX 3136, VERNON, CT 06066-2036
(860) 896-1422
(860) 896-1425
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
018083
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DB1187
MEDICARE RAIL ROAD
CT
01
—
P00087818
MEDICARE RAIL ROAD NUMBER DR. MARTIN
CT
01
—
P00269488
MEDICARE RAIL ROAD NUMBER DR. ANIS
CT
Enumeration date
06/10/2006
Last updated
08/05/2013
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