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Individual
ANDREW D MARTIN
Active
Individual
ANDREW D MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016005084
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016-005084
—
IL
01
—
480034880
RR MEDICARE
IL
01
—
7416406
AETNA
IL
Enumeration date
11/21/2005
Last updated
07/16/2008
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