Healthcare Provider Details

I. General information

NPI: 1063489656
Provider Name (Legal Business Name): A. MARTIN LERNER, MD,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32804 PIERCE ST
BEVERLY HILLS MI
48025-3215
US

IV. Provider business mailing address

32804 PIERCE ST
BEVERLY HILLS MI
48025-3215
US

V. Phone/Fax

Practice location:
  • Phone: 248-540-9866
  • Fax: 248-540-0139
Mailing address:
  • Phone: 248-540-9866
  • Fax: 248-540-0139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberAL025571
License Number StateMI

VIII. Authorized Official

Name: DR. A. MARTIN LERNER
Title or Position: PRESIDENT/OWNER
Credential: M.D.
Phone: 248-540-9866