Individual
JESSE ALLEN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226
(414) 955-6777
(414) 955-6203
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-6777
(414) 955-6203
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
60909
WI
207RC0000X
Cardiovascular Disease Physician
RT-3075
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144514571
—
WI
Enumeration date
06/02/2011
Last updated
08/22/2018
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