| Anthony Martin Mdms Pc | |
|
16001 W 9 Mile Rd Providence Hospital Southfield MI 48075-4818 | |
| (313) 971-3698 | |
| Not Available |
| Full Name | Anthony Martin Mdms Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 16001 W 9 Mile Rd, Southfield, Michigan |
| Authorized Official Name and Position | Anthony Martin (OWNER/PRESIDENT) |
| Authorized Official Contact | 7347920441 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anthony Martin Mdms Pc 10096 Hart Ave Huntington Woods MI 48070-1126 Ph: (248) 655-0337 | Anthony Martin Mdms Pc 16001 W 9 Mile Rd Providence Hospital Southfield MI 48075-4818 Ph: (313) 971-3698 |
| NPI Number | 1104849330 |
|---|---|
| Provider Enumeration Date | 07/26/2006 |
| Last Update Date | 02/29/2016 |
| Medicare PECOS PAC ID | 7012931595 |
|---|---|
| Medicare Enrollment ID | O20060124000139 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104849330 | NPI | - | NPPES |
| DE6518 | Other | PALMETTO GBA RAILROAD MR | |
| 4616478 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4301061359 (Michigan) | Primary |
| Provider Name | Anthony Martin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275579435 PECOS PAC ID: 0244213700 Enrollment ID: I20040608000350 |
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