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Individual

KEVIN B MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
123 SUMMER STREET, SUITE 390, WORCESTER, MA 01608
(508) 368-3120
(508) 368-3121
Mailing address
630 PLANTATION ST WOT 12TH FL, WORCESTER, MA 01605
(508) 368-3120
(508) 368-3121

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
214152
MA
207RP1001X
Pulmonary Disease Physician
Primary
214152
MA

Other

Enumeration date
11/02/2006
Last updated
02/18/2009
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