Individual
DR. KURT R MARTYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 S MAIN ST, MOSCOW, ID 83843-3056
(208) 882-4511
(208) 883-6580
Mailing address
1051 IDLERS REST RD, MOSCOW, ID 83843-8123
(208) 883-8331
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
M-9676
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HB184
BLUE CROSS ID
ID
Enumeration date
01/03/2007
Last updated
07/09/2007
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