Healthcare Provider Details

I. General information

NPI: 1780919936
Provider Name (Legal Business Name): MARTIN A V TUMA MD VASCULAR SURGERY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2009
Last Update Date: 08/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22255 GREEMFIELD ROAD #250
SOUTHFIELD MI
48075
US

IV. Provider business mailing address

22255 GREEMFIELD ROAD #250
SOUTHFIELD MI
48075
US

V. Phone/Fax

Practice location:
  • Phone: 248-559-1266
  • Fax: 248-559-5499
Mailing address:
  • Phone: 248-559-1266
  • Fax: 248-559-5499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number41055
License Number StateMI

VIII. Authorized Official

Name: DR. MARTIN A TUMA
Title or Position: OWNER
Credential: MD
Phone: 248-559-1266