Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 041055 | MI |
N | 208600000X | Surgeon | 041055 | MI |
Y | 2086S0129X | Vascular Surgeon | 041055 | MI |
NPI | 1154331858 |
---|---|
Provider Name | Dr. Martin A Tuma |
First Address | Southfield, MI 48075-3709 |
Second Address | Southfield, MI 48075-3709 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 24/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D83165 | (02) |