Individual
DR. MARTA R MORTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8793 WATSON RD, SAINT LOUIS, MO 63119-5111
(314) 961-0900
(314) 961-0909
Mailing address
8793 WATSON RD, SAINT LOUIS, MO 63119-5111
(314) 961-0900
(314) 961-0909
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
102738
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005014518
FPH
MO
05
—
205163306
—
MO
Enumeration date
05/18/2006
Last updated
02/26/2013
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