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Individual

MARK R ST. MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
26850 PROVIDENCE PKWY, SUITE 505, NOVI, MI 48374-1209
(248) 465-4163
(248) 465-4359
Mailing address
26850 PROVIDENCE PKWY, SUITE 505, NOVI, MI 48374-1209
(248) 465-4163
(248) 465-4359

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301082441
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4883284
MI
Enumeration date
03/29/2006
Last updated
11/10/2015
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