Basic Information
| Provider Information | |||||||||
| NPI: | 1942647250 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MARTIN-ENGEL | ||||||||
| FirstName: | LINDSAY | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3515 SHEPHERD LN | ||||||||
| Address2: | |||||||||
| City: | BALCH SPRINGS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 751802325 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9725884532 | ||||||||
| FaxNumber: | 2144289231 | ||||||||
| Practice Location | |||||||||
| Address1: | 5635 W FORT ST | ||||||||
| Address2: | |||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482093154 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8006536568 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/28/2013 | ||||||||
| LastUpdateDate: | 06/28/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 125063094 | IL | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 4301503917 | MI | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.