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Individual

ROBERT WILLIAM MARTIN III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
421 CHESTNUT ST, EVANSVILLE, IN 47713-1227
(812) 426-9355
(812) 858-4539
Mailing address
PO BOX 3868, EVANSVILLE, IN 47737-3868
(812) 426-9355
(812) 858-4539

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
01044875A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10825550
CAQH NUMBER
IN
05
200103290
IN
01
90774
PHCS PID NUMBER
IN
Enumeration date
03/17/2006
Last updated
09/10/2014
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