Provider Demographics
NPI:1649569906
Name:ST MARTIN, NSIKAN (MD)
Entity Type:Individual
Prefix:
First Name:NSIKAN
Middle Name:
Last Name:ST MARTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 MARQUIS MNR
Mailing Address - Street 2:
Mailing Address - City:MORGAN CITY
Mailing Address - State:LA
Mailing Address - Zip Code:70380-1151
Mailing Address - Country:US
Mailing Address - Phone:985-354-6081
Mailing Address - Fax:985-354-6087
Practice Address - Street 1:215 EVERETT ST
Practice Address - Street 2:
Practice Address - City:MORGAN CITY
Practice Address - State:LA
Practice Address - Zip Code:70380-3618
Practice Address - Country:US
Practice Address - Phone:985-354-6081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN12914207V00000X
LAMD.205672207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2315421Medicaid
LA2315421Medicaid