Provider Demographics
NPI:1386486587
Name:MARTIN, WILLIAM PATRICK (MB BCH BAO)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:PATRICK
Last Name:MARTIN
Suffix:
Gender:M
Credentials:MB BCH BAO
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Other - Credentials:
Mailing Address - Street 1:52 ARDILAUN COURT, SYBIL HILL ROAD
Mailing Address - Street 2:RAHENY
Mailing Address - City:DUBLIN
Mailing Address - State:LEINSTER
Mailing Address - Zip Code:D05 Y9N1
Mailing Address - Country:IE
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 BARNES JEWISH HOSPITAL PLZ
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1003
Practice Address - Country:US
Practice Address - Phone:314-362-7211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2024015198207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology