Provider Demographics
NPI:1588776058
Name:MARTIN, MICHAEL WINFIELD (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:WINFIELD
Last Name:MARTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3600 MEMORIAL BLVD
Mailing Address - Street 2:GEM CLINIC
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-5768
Mailing Address - Country:US
Mailing Address - Phone:830-792-2626
Mailing Address - Fax:830-792-2684
Practice Address - Street 1:3600 MEMORIAL BLVD
Practice Address - Street 2:GEM CLINIC
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-5768
Practice Address - Country:US
Practice Address - Phone:830-792-2626
Practice Address - Fax:830-792-2684
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXE6136207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine