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Individual

DR. MARTIN R A ALUMNO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3231 S NATIONAL AVE, SUITE 140, SPRINGFIELD, MO 65807-7304
(417) 890-4132
(417) 890-4140
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
116173
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
117821
MO BLUE SHIELD
MO
05
203769401
MO
01
81890
ARK BLUE SHIELD
AR
Enumeration date
02/06/2007
Last updated
05/01/2013
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