Provider Demographics
NPI:1417009432
Name:MARTIN I. APPLE, M.D., P.C.
Entity Type:Organization
Organization Name:MARTIN I. APPLE, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:GAYLE
Authorized Official - Last Name:FUERST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-358-3937
Mailing Address - Street 1:28905 NORTHWESTERN HWY
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1805
Mailing Address - Country:US
Mailing Address - Phone:248-358-3937
Mailing Address - Fax:248-358-0947
Practice Address - Street 1:28905 NORTHWESTERN HWY
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1805
Practice Address - Country:US
Practice Address - Phone:248-358-3937
Practice Address - Fax:248-358-0947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI044879207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1823578Medicaid
MIB44613Medicare UPIN
MI0M18370Medicare PIN