Individual
MARK CHRISTOPHER MARTINDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1717 LINCOLN WAY STE 108, COEUR D ALENE, ID 83814-2556
(208) 480-6174
(208) 601-6174
Mailing address
1717 LINCOLN WAY STE 108, COEUR D ALENE, ID 83814-2556
(208) 480-6174
(208) 601-6174
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-1937
OR
Other
Enumeration date
09/18/2019
Last updated
03/04/2025
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