Individual
CAROLYN M. MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
621 S NEW BALLAS RD STE 2007B, SAINT LOUIS, MO 63141-8265
(314) 991-5000
(314) 991-5035
Mailing address
621 S NEW BALLAS RD, SUITE 2007B, SAINT LOUIS, MO 63141-8232
(314) 991-5000
(314) 991-5035
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
R7824
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200990844
—
MO
Enumeration date
08/30/2005
Last updated
10/09/2018
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