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1720069008

NPI Code Detail

MEDICARE: SIDNEY NORBORNE MARTIN MD

MEDICARE: SIDNEY NORBORNE MARTIN 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	207X00000X	Orthopaedic Surgery Physician	4301407438	MI
2	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	4301407438	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	CB0923	OTHER		GROUP RAILROAD MEDICARE
4	0N45090	OTHER		GROUP MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0B51156	OTHER	MI	GROUP BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	1215930490	OTHER		TYPE 2 NPI

General Provider Information

NPI Number	:	1720069008
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIDNEY NORBORNE MARTIN MD

Provider Business Mailing Address
First Line	:	4466 W BRISTOL RD
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48507-3170
Country	:	US
Telephone Number	:	810-733-1200
Fax Number	:	810-733-0688

Provider Business Practice Location Address
First Line	:	4466 W BRISTOL RD
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48507-3170
Country	:	US
Telephone Number	:	810-733-1200
Fax Number	:	810-733-0688

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

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	09/19/2013

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Directions to “ SIDNEY NORBORNE MARTIN MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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