Individual
SHANE L MARTIN
Active
Individual
SHANE L MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
34339
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3Z5706
HEALTHNET
AZ
05
—
583819
—
AZ
Enumeration date
01/17/2006
Last updated
01/01/2023
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