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Individual

RICHARD J MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-7700
(216) 286-6341
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
35-039301
OH
207LP3000X
Pediatric Anesthesiology Physician
35-039301
OH
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
35-039301
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000028304
ANTHEM
OH
01
000000221385
UNISON
OH
01
000000526103
ANTHEM
OH
05
0310729
OH
05
1019304180001
PA
01
310729
BCMH
OH
01
363812
WELLCARE
OH
01
639973
AETNA
OH
01
745947
BUCKEYE
OH
Enumeration date
07/26/2006
Last updated
07/06/2011
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