Individual
MR. MICHAEL JAMES MARTIN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD.
Contact information
Practice address
12135 LANCASTER ST., MILLERSPORT, OH 43046-0218
(740) 467-2787
(740) 467-2450
Mailing address
PO BOX 218, MILLERSPORT, OH 43046-0218
(740) 467-2787
(740) 467-2450
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35-07-1374
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2077738
—
OH
Enumeration date
05/04/2006
Last updated
09/30/2013
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