Individual
DR. PETER RAY MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
715 PARK AVE, SOUTH BEND, IN 46616-1337
(574) 536-4151
Mailing address
715 PARK AVE, SOUTH BEND, IN 46616-1337
(574) 536-4151
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
323680
LA
Other
Enumeration date
03/27/2017
Last updated
01/08/2021
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