Provider Demographics
NPI:1538134507
Name:GUINTA, MARTIN FRANK (OD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:FRANK
Last Name:GUINTA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54774 SHERWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-1546
Mailing Address - Country:US
Mailing Address - Phone:586-781-2471
Mailing Address - Fax:586-731-8179
Practice Address - Street 1:45260 VAN DYKE AVE
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:MI
Practice Address - Zip Code:48317-5672
Practice Address - Country:US
Practice Address - Phone:586-731-1920
Practice Address - Fax:586-731-8179
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-22
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901002543152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0E06593Medicare ID - Type Unspecified
MIT33216Medicare UPIN