Provider Demographics
NPI:1093887929
Name:SOLOMON, MARTIN M (DO)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:M
Last Name:SOLOMON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:30141 CHERRY HILL RD
Mailing Address - Street 2:
Mailing Address - City:INKSTER
Mailing Address - State:MI
Mailing Address - Zip Code:48141-4019
Mailing Address - Country:US
Mailing Address - Phone:734-729-1150
Mailing Address - Fax:734-729-1807
Practice Address - Street 1:30141 CHERRY HILL RD
Practice Address - Street 2:
Practice Address - City:INKSTER
Practice Address - State:MI
Practice Address - Zip Code:48141-4019
Practice Address - Country:US
Practice Address - Phone:734-729-1150
Practice Address - Fax:734-729-1807
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MIMS007856207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E37954Medicare UPIN