Individual
SUSAN M MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3434 W STATE ROAD 66, ROCKPORT, IN 47635-9259
(812) 649-5061
(812) 649-5224
Mailing address
PO BOX 3868, EVANSVILLE, IN 47737-3868
(812) 649-5061
(812) 649-5224
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01032026A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000109430
ANTHEM
IL
05
—
100189280
—
IN
01
—
64756786
KY MEDICAID
KY
Enumeration date
11/29/2006
Last updated
01/03/2013
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