Individual
SHELLY R MARTYNIAKPA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
2222 S LINDEN RD, SUITE A, FLINT, MI 48532-5475
(810) 733-0790
(810) 733-1817
Mailing address
2222 S LINDEN RD, SUITE A, FLINT, MI 48532-5475
(810) 733-0790
(810) 733-1817
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601002850
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SM002850
BCBS STATE LICENSE
MI
Enumeration date
01/31/2008
Last updated
06/04/2010
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