Individual
DAVID THOMAS MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 672-7422
Mailing address
1411 E 31ST ST, QIC 22134, OAKLAND, CA 94602-1018
(510) 437-4965
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
64024
MN
2086S0102X
Surgical Critical Care Physician
Primary
64024
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/14/2011
Last updated
04/15/2019
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