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NPI Code Detail

MEDICARE: DR. RAUL MARTIN MD

MEDICARE: DR. RAUL MARTIN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician2001011421MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770588394
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RAUL MARTIN MD
Provider Business Mailing Address
First Line : 5655 HUDSON DR STE 210
Second Line : ARIS RADIOLOGY
City : HUDSON
State : OH
Zip : 44236-4455
Country : US
Telephone Number : 330-655-1869
Fax Number : 330-655-3828
Provider Business Practice Location Address
First Line : 5655 HUDSON DR STE 210
Second Line : ARIS RADIOLOGY
City : HUDSON
State : OH
Zip : 44236-4455
Country : US
Telephone Number : 330-655-1869
Fax Number : 330-655-3828
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2005
Last Update Date : 11/09/2016

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Directions to “ DR. RAUL MARTIN MD” Practice Location

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