Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 4301093995 | MI |
NPI | 1275572323 |
---|---|
Provider Name | Dr. Steven Wayne Martin |
First Address | East Lansing, MI 48823-3125 |
Second Address | Lansing, MI 48912-1811 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 23/05/2012 |