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General NPI Number Information
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NPI Number | 1992016117
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Entity Type | Organization
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Legal Business Name | MARTIN HART, M.D., P.C.
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Dates
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Enumeration Date | 06/23/2010
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Last Update Date | 06/23/2010
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Provider Practice Location Address
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Address Line | 7561 HIGHLAND RD
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City | WATERFORD
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State | MI
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Zip | 48327-1405
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Country | US
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Telephone | 248-666-1400
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Fax | 248-666-2404
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Provider Business Mailing Address
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Address Line | 7561 HIGHLAND RD
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City | WATERFORD
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State | MI
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Zip | 48327-1405
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Country | US
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Telephone | 248-666-1400
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Fax | 248-666-2404
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. MARTIN HART
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Credential | MD
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Telephone | 248-666-1400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 4301026680
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License Number State | MI
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