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DR. MARTIN GERARD WUNSCH PH.D.

Clinical Neuropsychologist

Clinton Township, Michigan

Provider NPI: 1871560326

Provider Information:
DR. MARTIN GERARD WUNSCH PH.D.
Gender: M


Practice Location:
43211 DALCOMA DR SUITE 11 CLINTON TOWNSHIP, MI 48038 US
Tel: 586-263-0947  Fax: 248-267-5899

Business Mailing Address:
1728 BRENTWOOD DR  TROY, MI 48098 US
Tel: 586-263-0947  Fax: 248-267-5899

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
X103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
MI6301005658
X103T00000XBehavioral Health & Social Service Providers
Psychologist
MI6301005658
X103TC0700XBehavioral Health & Social Service Providers
Psychologist
MI6301005658

Other Provider Identifiers:

IssuerNumberStateType
TRICAREIP045740MI01
VALUE OPTIONS122159MI01
HEALTH NET5842MI01
BLUE CROSS BLUE SHIELD68OF33054MI01
MANAGED HEALTH NETWORK, I207862MI01
AETNA BEHAVIORAL HEALTH5076046MI01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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