Provider Demographics
NPI:1457646374
Name:MARTIAN, KEVIN F (PHARMD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:F
Last Name:MARTIAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-4020
Mailing Address - Country:US
Mailing Address - Phone:701-223-2424
Mailing Address - Fax:701-258-2849
Practice Address - Street 1:303 N 4TH ST
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-4020
Practice Address - Country:US
Practice Address - Phone:701-223-2424
Practice Address - Fax:701-258-2849
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND5378183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist