Individual
DR. MARTIN WILLIAM JENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
26850 PROVIDENCE PARKWAY, SUITE 355, NOVI, MI 48374-1209
(248) 347-2435
(248) 347-3608
Mailing address
26850 PROVIDENCE PARKWAY, SUITE 355, NOVI, MI 48374-1209
(248) 755-1472
(248) 347-3608
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
5101011365
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200F318000
BCBSM PRACTICE PIN
MI
01
—
383607217
P.C. TAX ID
MI
05
—
4791638
—
MI
Enumeration date
12/15/2005
Last updated
04/22/2024
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