Individual
RICHARD ALLAN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
150 SOUTH MOUNT AUBURN ROAD, SUITE 420, CAPE GIRARDEAU, MO 63703
(573) 335-4448
(573) 335-4466
Mailing address
150 SOUTH MOUNT AUBURN ROAD, SUITE 420, CAPE GIRARDEAU, MO 63703
(573) 335-4448
(573) 335-4466
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
R8494
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200764918
—
MO
01
—
211029
HEALTHLINK
—
01
—
27666
BLUE CROSS
MO
Enumeration date
09/07/2005
Last updated
04/05/2010
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