Provider Demographics
NPI:1699750356
Name:ARKIN, MARTIN SAMUEL (MD)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:SAMUEL
Last Name:ARKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10161 E PICKWICK CT
Mailing Address - Street 2:SUITE C
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-5239
Mailing Address - Country:US
Mailing Address - Phone:231-935-0630
Mailing Address - Fax:231-935-0639
Practice Address - Street 1:10161 E PICKWICK CT
Practice Address - Street 2:SUITE C
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-5239
Practice Address - Country:US
Practice Address - Phone:231-935-0630
Practice Address - Fax:231-935-0639
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301064341207WX0120X
MIMA064341207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0120XAllopathic & Osteopathic PhysiciansOphthalmologyCornea and External Diseases Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP00094336OtherPALMETTO GBA RR MEDICARE
MI4654497Medicaid
MIMA064341OtherLICENSE NUMBER
MIF42437Medicare UPIN
MIP00094336OtherPALMETTO GBA RR MEDICARE