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Individual

RICHARD J MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4400 E FLAMINGO, STE 200, NAMPA, ID 83687
(208) 302-2700
(208) 302-2725
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 302-2700
(208) 302-2725

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
M-7952
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
805719700
ID
Enumeration date
04/13/2006
Last updated
11/09/2017
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