Martin, Michael
Martin, Michael is an individual health care provider with primary practice located at 1504 Sullivan Ave , South Windsor CT 06074-2711. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Martin, Michael can be contacted via phone (860) 644-1523.Contact Information
Primary practice address
1504 Sullivan Ave
South Windsor CT 06074-2711
Phone: (860) 644-1523
Fax: (860) 648-9468
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 018063 | Connecticut |
Profile Details
| NPI number | 1952364341 |
|---|---|
| LBN Legal business name | Martin, Michael |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 8th, 2006 |
| Last updated | Jun 7th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952364341 | NPPES |
| Connecticut | Other | 010018083CT02 | ANTHEM |
| Connecticut | Other | P00087818 | ANTHEM |
| Connecticut | MEDICAID | 1952364341 | ANTHEM |
| Connecticut | Other | 018083 | ANTHEM |
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