MEDICARE: MR. JOHN A MARTINI MD

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
1	207Q00000X	Family Medicine Physician	25991	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033119276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN A MARTINI MD

Provider Business Mailing Address
First Line	:	111 E WISCONSIN AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53202-4815
Country	:	US
Telephone Number	:	414-290-6700
Fax Number	:

Provider Business Practice Location Address
First Line	:	9555 76TH ST
Second Line	:
City	:	PLEASANT PRAIRIE
State	:	WI
Zip	:	53158-1984
Country	:	US
Telephone Number	:	262-671-7050
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	09/10/2024

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Directions to “ MR. JOHN A MARTINI MD” Practice Location

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