Provider Demographics
NPI:1225166531
Name:ZELLA, MARTIN D (DC)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:D
Last Name:ZELLA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 S MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-2634
Mailing Address - Country:US
Mailing Address - Phone:517-548-1333
Mailing Address - Fax:517-548-4922
Practice Address - Street 1:721 S MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-2634
Practice Address - Country:US
Practice Address - Phone:517-548-1333
Practice Address - Fax:517-548-4922
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005371111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950D752170OtherBLUE SHIELD PROVIDER
MIDO1942OtherRAILROAD MEDICARE PART B PTAN
MIT33105Medicare UPIN
MI0D75217Medicare PIN