Individual
DR. ERICA LYN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
530 N LAFAYETTE BLVD, THE MEDICAL FOUNDATION, SOUTH BEND, IN 46601-1004
(574) 234-4176
Mailing address
530 N LAFAYETTE BLVD, THE MEDICAL FOUNDATION, SOUTH BEND, IN 46601-1004
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
01073029A
IN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
35.123363
OH
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
4301106547
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/07/2009
Last updated
07/23/2015
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