Organization
DANIEL J MARTIN JR MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL J MARTIN JR. M.D. (PHYSICIAN)
(314) 567-5850
Entity
Organization
Contact information
Practice address
621 S NEW BALLAS RD, 5015B, SAINT LOUIS, MO 63141-8232
(314) 567-5850
(314) 567-9169
Mailing address
621 S NEW BALLAS RD, 5015B, SAINT LOUIS, MO 63141-8232
(314) 567-5850
(314) 567-9169
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MDR1P08
MO
Other
Enumeration date
02/01/2012
Last updated
07/03/2012
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