Individual
ROBERT M MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
201 CEDAR SE SUITE 4640, PMG CEDAR ENT, ALBUQUERQUE, NM 87106
(505) 563-6450
(505) 563-6484
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5356
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
PA2002-0009
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
62325353
—
NM
Enumeration date
03/20/2007
Last updated
08/15/2008
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