Individual
DOUGLAS MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
300 LAKE DR E, CHANHASSEN, MN 55317-9302
(952) 993-4300
Mailing address
3800 PARK NICOLLET BLVD, CREDENTIALING, ST LOUIS PARK, MN 55416-2527
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
23593
MN
Other
Enumeration date
12/20/2005
Last updated
03/05/2012
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