Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | MD0027305 | WA |
NPI | 1003860495 |
---|---|
Provider Name | Dr. Robert D Martz |
First Address | Spokane, WA 99204-2302 |
Second Address | Spokane, WA 99204-2302 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2006 |
Last Update Date | 13/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8118036 | (05) | WA |
F02410 | (02) | WA |