Individual
GORDON HUNTER MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
J5107
TX
2086S0129X
Vascular Surgery Physician
Primary
J5107
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
096412404
—
TX
01
—
1914907
UNITED HEALTHCARE
TX
01
—
5173755
AETNA
TX
01
—
8W7600
BCBS
TX
Enumeration date
07/29/2005
Last updated
08/14/2024
Update your record
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