Individual
CASEY S. MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
580 RICE ST, SAINT PAUL, MN 55103-2148
(651) 227-6551
(651) 665-0684
Mailing address
580 RICE ST, SAINT PAUL, MN 55103-2148
(651) 227-6551
(651) 665-0684
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
38855
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-03705
MEDICA CHOICE/DUAL/PTCH #
MN
01
—
1016634
PREFERRED ONE NUMBER
MN
01
—
112864
UCARE NUMBER
MN
05
—
1536748
—
IA
01
—
26G29MA
BCBS NUMBER
MN
05
—
34284200
—
WI
01
—
773469
AMERICA'S PPO NUMBER
MN
01
—
HP26164
HEALTHPARTNERS NUMBER
MN
Enumeration date
09/26/2006
Last updated
07/09/2007
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