Individual
DR. DELLICE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
300 1ST CAPITOL DR, SAINT CHARLES, MO 63301-2844
(636) 947-5162
Mailing address
300 1ST CAPITOL DR, SAINT CHARLES, MO 63301-2844
(636) 947-5162
(636) 949-7273
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
101041
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208951426
—
MO
Enumeration date
02/10/2006
Last updated
05/24/2021
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