Individual
MICHAEL MARTIN
Active
Individual
MICHAEL MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
018063
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010018083CT02
ANTHEM
CT
01
—
018083
CTCARE
CT
05
—
1952364341
—
CT
01
—
P00087818
MEDICARE RAILROAD
CT
Enumeration date
04/08/2006
Last updated
06/07/2010
Update your record
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