Individual
DR. JESSE MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
9377 N HAGGERTY RD, PLYMOUTH, MI 48170-4622
(734) 451-0070
(734) 451-1583
Mailing address
23900 ORCHARD LAKE RD, STE 150, FARMINGTON HILLS, MI 48336-2500
(248) 234-8690
(248) 234-8690
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5101012766
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4166042-11
—
MI
05
—
4387007-11
—
MI
Enumeration date
10/05/2005
Last updated
01/08/2019
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