Healthcare Provider Details

I. General information

NPI: 1225471741
Provider Name (Legal Business Name): CARIN MARIE MARTINSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARIN MARIE RAMBOW

II. Dates (important events)

Enumeration Date: 04/15/2013
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HEALTHY WAY
OLIVIA MN
56277-1117
US

IV. Provider business mailing address

100 HEALTHY WAY
OLIVIA MN
56277-1117
US

V. Phone/Fax

Practice location:
  • Phone: 605-339-1783
  • Fax:
Mailing address:
  • Phone: 320-523-1460
  • Fax: 320-523-8349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number62581
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: