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NPI Code Detail

MEDICARE: DR. MINNIE LEE MARTIN M.D.

MEDICARE:  DR. MINNIE LEE MARTIN  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician4301069658MI

Other Identifiers

General Provider Information

NPI Number : 1760565584
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MINNIE LEE MARTIN M.D.
Provider Business Mailing Address
First Line : PO BOX 1239
Second Line :
City : TROY
State : MI
Zip : 48099-1239
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1484 STRAITS DR
Second Line : STE 5
City : BAY CITY
State : MI
Zip : 48706-8718
Country : US
Telephone Number : 989-667-8740
Fax Number : 989-667-8745
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2006
Last Update Date : 05/19/2015

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Directions to “ DR. MINNIE LEE MARTIN M.D.” Practice Location

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