Individual
MARTHA J SHORT
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1414 W FAIR AVE, STE 201, MARQUETTE, MI 49855-5406
(906) 225-4500
(906) 225-3919
Mailing address
223 SANDSTONE DR, MARQUETTE, MI 49855-5200
(906) 228-3255
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301054632
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110E26038
BCBSM
MI
05
—
3110839
—
MI
Enumeration date
06/13/2005
Last updated
07/08/2007
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