Individual
LOUISE EVELYN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11250 E 13 MILE RD, STE 2B, WARREN, MI 48093-2597
(586) 751-2520
(586) 751-7004
Mailing address
11250 E 13 MILE RD, STE 2B, WARREN, MI 48093-2597
(586) 751-2520
(586) 751-7004
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301059389
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LM059389
BCBSM
MI
Enumeration date
10/06/2006
Last updated
07/08/2007
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