Organization
CENTRUM CARDIOLOGY, LTD
Active
Organization
CENTRUM CARDIOLOGY, LTD
Active
Other names
Randolph S Martin, MD, SC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDOLPH S. MARTIN M.D. (PRESIDENT)
(217) 546-0750
Entity
Organization
Contact information
Practice address
319 E MADISON ST STE 2D, SPRINGFIELD, IL 62701-3120
(217) 546-0750
(217) 546-0894
Mailing address
319 E MADISON ST STE 2D, SPRINGFIELD, IL 62701-3120
(217) 546-0750
(217) 546-0894
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036079474
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008092
HEALTH ALLIANCE
IL
05
—
036079474
—
IL
01
—
08432108
BLUE CROSS BLUE SHIELD
IL
01
—
133621
HEALTHLINK, INC
IL
01
—
222623
COVENTRY HEATH CARE
IL
01
—
823599
FIRST HEALTH
IL
01
—
9683056002
CIGNA
IL
01
—
P00140870
RAILROAD MEDICARE
IL
Enumeration date
10/02/2007
Last updated
07/21/2022
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