Provider Demographics
NPI:1962663302
Name:HINZ, MARTIN CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:CHARLES
Last Name:HINZ
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 1:1150 88TH AVE W
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55808-1505
Mailing Address - Country:US
Mailing Address - Phone:218-626-2220
Mailing Address - Fax:218-626-1638
Practice Address - Street 1:1150 88TH AVE W
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55808-1505
Practice Address - Country:US
Practice Address - Phone:218-626-2220
Practice Address - Fax:218-626-1638
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN31670207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine