Organization Active NPI

Anthony Martin MDMS PC

  • Internal Medicine Physician
  • Southfield, MI
National Provider Identifier
1104849330
Registry record updated Feb 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301061359 Issued in MI
Legal business name
ANTHONY MARTIN MDMS PC
Practice address
16001 W 9 Mile Rd
Providence Hospital
Southfield, MI 48075-4818
Phone
(313) 971-3698
NPI assigned
Jul 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Anthony Martin, MD
Title
Owner/President
Phone
(734) 792-0441

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 4301061359 MI Primary

Addresses

Primary practice location

16001 W 9 Mile Rd
Providence Hospital
Southfield, MI 48075-4818

Mailing address

10096 Hart Ave
Huntington Woods, MI 48070-1126
Phone (248) 655-0337

Other identifiers 2

IdentifierTypeStateIssuer
DE6518OtherPALMETTO GBA RAILROAD MR
4616478MedicaidMI

National Provider Directory

National Provider Directory

Locations

20202 Farmington Rd
Livonia, MI 48152
Phone (248) 426-0110

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456704000000",
    "number": "1104849330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10096 HART AVE",
            "city": "HUNTINGTON WOODS",
            "state": "MI",
            "postal_code": "480701126",
            "telephone_number": "248-655-0337",
            "fax_number": "248-655-0339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16001 W 9 MILE RD",
            "address_2": "PROVIDENCE HOSPITAL",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754818",
            "telephone_number": "313-971-3698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHONY MARTIN MDMS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2016-02-29",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "734-792-0441",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301061359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA RAILROAD MR",
            "identifier": "DE6518",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4616478",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.