Provider Demographics
NPI:1154331858
Name:TUMA, MARTIN A (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:A
Last Name:TUMA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:23077 GREENFIELD RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-3709
Mailing Address - Country:US
Mailing Address - Phone:947-282-6304
Mailing Address - Fax:248-796-8182
Practice Address - Street 1:23077 GREENFIELD RD
Practice Address - Street 2:SUITE 110
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-3709
Practice Address - Country:US
Practice Address - Phone:947-282-6304
Practice Address - Fax:248-796-8182
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2016-05-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI041055208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
D83165Medicare UPIN
0630705Medicare ID - Type Unspecified