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Individual
JOHN ARTHUR MARTIN
Active
Individual
JOHN ARTHUR MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601001218
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080G310660
BLUE CROSS BLUE SHIELD MI
MI
01
—
1012014
HEALTH ADVANTAGE PPO
—
01
—
146037
GREAT LAKES HEALTH PLAN
—
01
—
260
COMMUNITY CHOICE
MI
01
—
2832651
MOLINA HEALTH CARE
MI
01
—
381908328
TRICARE
—
Enumeration date
10/06/2005
Last updated
01/31/2011
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