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General NPI Number Information
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NPI Number | 1164816013
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Entity Type | Individual
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Provider Name | MARKO MARTINOVSKI M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/27/2015
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 950 E MAPLE RD STE L4
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City | BIRMINGHAM
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State | MI
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Zip | 48009-6482
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Country | US
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Telephone | 313-580-7893
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Fax |
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Provider Business Mailing Address
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Address Line | 950 E MAPLE RD STE L4
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City | BIRMINGHAM
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State | MI
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Zip | 48009-6482
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 4301107142
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 4301107142
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License Number State | MI
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