Individual
MICHELLE C MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1400 VFW PKWY, WEST ROXBURY, MA 02132-4927
(857) 203-6200
Mailing address
6 SUMMER LN, WAYLAND, MA 01778-2927
(617) 833-5413
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
233183
MA
2086S0129X
Vascular Surgery Physician
Primary
233183
MA
Other
Enumeration date
12/21/2007
Last updated
11/09/2020
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