Individual
MARTHA D CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD PHD
Contact information
Practice address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
(734) 936-4000
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301065723
MI
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
4301065723
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4222713
—
MI
Enumeration date
07/31/2006
Last updated
11/25/2019
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