Provider Demographics
NPI:1144396672
Name:STEDMAN, MARTIN JAMES (MD)
Entity Type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:JAMES
Last Name:STEDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7332 KENNEDY BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047
Mailing Address - Country:US
Mailing Address - Phone:201-662-0900
Mailing Address - Fax:201-662-9622
Practice Address - Street 1:7332 KENNEDY BOULEVARD
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047
Practice Address - Country:US
Practice Address - Phone:201-662-0900
Practice Address - Fax:201-662-9622
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02799200208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0483702Medicaid
NJ033867Medicare ID - Type Unspecified
NJ0483702Medicaid