NPI 1629053236

Nicholaus Bruce Martin, MD

Practitioner General Practice Physician Flagstaff, AZ

Practice location

Address: 120 W Fine Ave, Flagstaff, AZ 86001-3016
Phone: (928) 773-9695
Fax: (928) 773-0208

Registered specialties (2)

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence 18430 (AZ)

Other General Practice providers in Arizona →

General Practice Physician

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence 40573 (CO)

Registry record

NPI: 1629053236
Entity type: Individual
Sex (as registered): Male
NPI issued: 7 Dec 2005
Record last updated: 22 Jan 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.