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General NPI Number Information
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NPI Number | 1619966058
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Entity Type | Individual
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Provider Name | STEVEN C MARTIN MD
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Gender | Male
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Dates
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Enumeration Date | 10/18/2005
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 3545 WESTMORELAND DR
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City | WEST LAFAYETTE
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State | IN
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Zip | 47906-8756
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Country | US
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Telephone | 765-412-7709
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Fax |
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Provider Business Mailing Address
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Address Line | 150 HARVESTER DR STE 300
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City | BURR RIDGE
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State | IL
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Zip | 60527-5965
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Country | US
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Telephone |
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101261638
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301104697
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD16478
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License Number State | RI
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036161665
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | E-11879
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License Number State | AR
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Taxonomy #6
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 081939
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License Number State | GA
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Taxonomy #7
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | C159538
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License Number State | CA
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Taxonomy #8
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01068276A
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License Number State | IN
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