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Individual

DR. MARY LOUISE MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3223 8TH ST, METAIRIE, LA 70002-1623
(504) 833-7770
Mailing address
PO BOX 276, ZACHARY, LA 70791-0276
(626) 394-3198
(225) 654-8750

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
A99897
CA
207P00000X
Emergency Medicine Physician
Primary
MD.203324
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0080563
LA
01
P00787988
RAILROAD MCARE THRU PEPA
Enumeration date
08/10/2007
Last updated
06/25/2010
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