Individual
DR. RICHARD KYLE MACIVER MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, FRCSC
Contact information
Practice address
1900 CENTRACARE CIR, SAINT CLOUD, MN 56303-5000
(320) 253-2663
Mailing address
1900 CENTRACARE CIR, SAINT CLOUD, MN 56303-5000
(320) 253-2663
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
63139
MN
Other
Enumeration date
10/02/2018
Last updated
07/18/2024
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