# MARTIN BOUBLIK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1447256979
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 30838 | CO | Yes |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | 30838 | CO | — |
| 207XX0801X | Orthopaedic Trauma Physician | 30838 | CO | — |

## Other

- **Enumeration date:** 06/21/2005
- **Last updated:** 09/09/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | BO37325 | BCBS | CO |