Individual
STANLEY B MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
508 JEFFERSON ST, SAINT CHARLES, MO 63301-2703
(636) 946-3670
(636) 946-5421
Mailing address
508 JEFFERSON ST, SAINT CHARLES, MO 63301-2703
(636) 946-3670
(636) 946-5421
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
102927
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
506873009
—
MO
Enumeration date
08/23/2006
Last updated
10/23/2020
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