Individual
STEVEN DOUGLAS MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1 MEDICAL VILLAGE DRIVE, EDGEWOOD, KY 41017-3403
(859) 301-2000
(859) 426-4140
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 426-0800
(859) 426-4140
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
07307
OH
363L00000X
Nurse Practitioner
Primary
3002999
KY
363LF0000X
Family Nurse Practitioner
NP-07307
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0369017
MEDICARE
KY
01
—
0369211
MEDICARE
KY
01
—
0562617
MEDICARE
KY
01
—
611300608058
CARESOURCE
OH
05
—
78003274
—
KY
Enumeration date
07/07/2005
Last updated
10/11/2019
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