Doctor Name: | DR. JESUS MARTINEZ |
NPI Number: | 1710941265 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | JM031056 |
Business Practice Address: | 2142 Monroe St Dearborn, MI - 481243057 |
Business Phone Number: | 7344597444 |
Business Fax Number: | 7344597755 |
Mailing Address: | 2142 Monroe St, DEARBORN |
State: | MI |
Postal Code: | 481243057 |
Phone Number: | 7344597444 |
Fax Number: | 7344597755 |
NPI Enumeration Date: | 04/13/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | JM031056 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |