Individual
STEPHEN C MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6052 W STATE ST, BOISE, ID 83703-2739
(208) 344-7799
(208) 344-7152
Mailing address
6052 W STATE ST, BOISE, ID 83703-2739
(208) 344-7799
(208) 344-7152
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M9294
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807115800
—
ID
01
—
P00241787
RR MEDICARE
—
Enumeration date
06/10/2006
Last updated
01/28/2010
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