Kornblum, Martin
Kornblum, Martin is an individual health care provider with primary practice located at 11885 E 12 Mile Rd 200B, Warren MI 48093-3474. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine, which is considered as his primary health care specialty. Kornblum, Martin can be contacted via phone (586) 582-7070.Contact Information
Primary practice address
11885 E 12 Mile Rd 200B
Warren MI 48093-3474
Phone: (586) 582-7070
Fax: (586) 582-7066
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine | 207XS0117X | 4301063387 | Michigan |
Profile Details
| NPI number | 1679562722 |
|---|---|
| LBN Legal business name | Kornblum, Martin |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 20th, 2005 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679562722 | NPPES |
| Michigan | MEDICAID | 4209319 |
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