Individual
DR. PETER MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 N 1ST ST, SPRINGFIELD, IL 62781-0001
(217) 788-5495
Mailing address
PO BOX 17037, URBANA, IL 61803-7037
(800) 897-6169
(800) 897-6170
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036075514
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036075514
BC OF IL
IL
05
—
036075514
—
IL
Enumeration date
01/13/2006
Last updated
07/08/2007
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