Individual
MARTIN KORNBLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11885 E 12 MILE RD, 200B, WARREN, MI 48093-3474
(586) 582-7070
(586) 582-7066
Mailing address
43800 GARFIELD RD, CLINTON TWP, MI 48038-1136
(800) 848-0202
(586) 226-6949
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
4301063387
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4209319
—
MI
Enumeration date
10/20/2005
Last updated
07/08/2007
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