Individual
PETER E MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2200 CEDARCREST DR, STE B, RICE LAKE, WI 54868
(586) 864-6006
(952) 442-3620
Mailing address
400 10TH ST E, WACONIA, MN 55387-4552
(952) 442-9770
(952) 442-3620
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
122792-30
WI
Other
Enumeration date
04/19/2023
Last updated
04/19/2023
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