Individual
MARY A MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
12880 MANNING LAKE RD, DELTON, MI 49046-9659
(269) 999-9999
Mailing address
12880 MANNING LAKE RD, DELTON, MI 49046-9659
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
4704165662
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2951920
—
MI
Enumeration date
01/19/2006
Last updated
01/12/2024
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