Martinez, Misha Lee Taber
Martinez, Misha Lee Taber is an individual health care provider with primary practice located at 3165 Myrtle Ave Ste 2 , Granite City IL 62040-5012. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Martinez, Misha Lee Taber can be contacted via phone (618) 876-7500.Contact Information
Primary practice address
3165 Myrtle Ave Ste 2
Granite City IL 62040-5012
Phone: (618) 876-7500
Fax: (618) 876-0807
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 036-129509 | Illinois |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 2011012182 | Missouri |
Profile Details
| NPI number | 1528221082 |
|---|---|
| LBN Legal business name | Martinez, Misha Lee Taber |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 4th, 2008 |
| Last updated | Jan 26th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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