Individual
MR. MICHAEL E MARTIN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2461 SUMMERFIELD RD, SANTA ROSA, CA 95405-7815
(707) 525-0211
(707) 525-0491
Mailing address
2461 SUMMERFIELD RD, SANTA ROSA, CA 95405-7815
(707) 525-0211
(707) 525-0491
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
G29076
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G29076
LICENSE
CA
05
—
GR0061440
—
CA
Enumeration date
11/29/2005
Last updated
07/08/2007
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