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Individual

MS. SHELBY MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
4500 FOREST PARK AVE, DIV SURG ONCOLOGY, 8TH FL, SAINT LOUIS, MO 63108-2114
(314) 362-2280
(888) 352-8360
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 362-2280
(888) 352-8360

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2025010660
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
220156750
MO
Enumeration date
06/19/2022
Last updated
06/06/2025
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