Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RG0100X | Gastroenterologist | 35030461 | OH |
N | 2086X0206X | Surgical Oncologist | 35030461 | OH |
N | 208C00000X | Colorectal Surgeon | 35030461 | OH |
NPI | 1194927533 |
---|---|
Provider Name | Dr. John Craig Martin |
First Address | Kirtland Hills, OH 44060 |
Second Address | Kirtland Hills, OH 44060 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2007 |
Last Update Date | 08/07/2007 |