Individual
DAVID STUART MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
915 NORTH GRAND BOULEVARD, SAINT LOUIS, MO 63106
(636) 532-9294
Mailing address
14603 BIG TIMBER LANE, CHESTERFIELD, MO 63017
(636) 532-9294
(405) 948-6507
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
036052082
IL
2085R0202X
Diagnostic Radiology Physician
Primary
R6146
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1357740
BCBS OF TN
TN
Enumeration date
06/02/2006
Last updated
12/04/2012
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