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General NPI Number Information
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NPI Number | 1487765426
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Entity Type | Individual
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Provider Name | ROBERT S MARTIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 01/14/2021
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Provider Practice Location Address
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Address Line | 3015 N BALLAS RD
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City | SAINT LOUIS
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State | MO
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Zip | 63131-2329
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Country | US
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Telephone | 314-996-5000
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Fax | 314-996-4611
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Provider Business Mailing Address
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Address Line | 3015 N BALLAS RD
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City | SAINT LOUIS
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State | MO
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Zip | 63131-2329
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Country | US
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Telephone | 314-996-5000
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Fax | 314-996-4611
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 100869
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License Number State | MO
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