Provider Demographics
NPI:1356717367
Name:MARTIN, MONIKA (MD)
Entity type:Individual
Prefix:
First Name:MONIKA
Middle Name:
Last Name:MARTIN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:MONIKA
Other - Middle Name:
Other - Last Name:FOSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1327
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53008-1327
Mailing Address - Country:US
Mailing Address - Phone:414-447-7330
Mailing Address - Fax:414-447-1070
Practice Address - Street 1:3070 N 51ST ST # P309
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53210-1645
Practice Address - Country:US
Practice Address - Phone:414-447-7330
Practice Address - Fax:414-447-1070
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI75172-202080N0001X
WI7517220208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine