Provider Demographics
NPI:1063489656
Name:A. MARTIN LERNER, MD,PC
Entity Type:Organization
Organization Name:A. MARTIN LERNER, MD,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:A.
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:LERNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-540-9866
Mailing Address - Street 1:32804 PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-3215
Mailing Address - Country:US
Mailing Address - Phone:248-540-9866
Mailing Address - Fax:248-540-0139
Practice Address - Street 1:32804 PIERCE ST
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:MI
Practice Address - Zip Code:48025-3215
Practice Address - Country:US
Practice Address - Phone:248-540-9866
Practice Address - Fax:248-540-0139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAL025571261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2124295Medicaid
MI2124295Medicaid
MID91447Medicare UPIN