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Individual

SARA JEAN MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
12099 ALCOTT DR, SAUK CENTRE, MN 56378-4744
(320) 267-3479
Mailing address
12099 ALCOTT DR, SAUK CENTRE, MN 56378-4744
(320) 267-3479

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
55408
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0001-0100298
MEDICA
01
1891087276
BCBS
MN
05
1891087276
MN
01
P01099796
RR MEDICARE
Enumeration date
05/04/2011
Last updated
07/10/2021
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