Individual
MR. MARK J MARTINEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1700 CERILLOS ROAD, SANTA FE, NM 87505
(505) 946-9557
Mailing address
7033 VUELTA VISTOSO, SANTA FE, NM 87507
(505) 660-3156
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN081644
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
422585
—
AZ
Enumeration date
06/13/2006
Last updated
07/08/2007
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