Michael Martin, MD
Internal Medicine in South Windsor, CT. Individual provider (NPI-1).
NPI number1952364341
StatusActive
Last updated in NPPESJun 7, 2010
Details
- NPI
- 1952364341
- Entity type
- Individual (NPI-1)
- Name
- Michael Martin
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 8, 2006
- Last updated
- Jun 7, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | 018063 | CT | Yes |
Practice location
1504 Sullivan AveSouth Windsor, CT 06074-2711
Phone 860-644-1523 · Fax 860-648-9468
Mailing address
Po Box 3136Vernon, CT 06066-2036
Phone 860-896-1422 · Fax 860-896-1425
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