Individual
ADAM J MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
621 S NEW BALLAS RD STE 3005B, SAINT LOUIS, MO 63141-8266
(314) 251-7069
Mailing address
3333 EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9493
(616) 364-4200
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4301506762
MI
207X00000X
Orthopaedic Surgery Physician
2017022178
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301506762
MI BOARD OF MEDICINE
MI
Enumeration date
06/29/2017
Last updated
09/07/2022
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