Individual
DR. JENNIFER E MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4201 SAINT ANTOINE ST, SUITE 3R, DETROIT, MI 48201-2153
(313) 745-3330
Mailing address
4201 ST ANTOINE, SUITE 3R, DETROIT, MI 48201-2153
(313) 745-3330
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301076858
MI
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
4301076858
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104625332
—
MI
05
—
104625350
—
MI
05
—
104625641
—
MI
01
—
JM076858
BC/BS OF MI
MI
Enumeration date
03/20/2006
Last updated
06/17/2010
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