Individual
DR. MARTIN J REPETTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1504 PATTON DR, MAHOMET, IL 61853-8144
(217) 586-2633
Mailing address
1120 N MELVIN ST, GIBSON CITY, IL 60936-1477
(217) 784-2579
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036118864
IL
2084P0800X
Psychiatry Physician
ME85073
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
270255000
—
FL
Enumeration date
06/07/2006
Last updated
08/05/2024
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