Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 2009-01485 | NC |
N | 204F00000X | Transplant Surgeon | 25MA07434600 | NJ |
Y | 204F00000X | Transplant Surgeon | C100010447 | DE |
N | 204F00000X | Transplant Surgeon | MD448939 | PA |
N | 204F00000X | Transplant Surgeon | ME126220 | FL |
N | 208200000X | Surgeon | 2009-01485 | NC |
N | 208600000X | Surgeon | 2009-01485 | NC |
N | 208200000X | Surgeon | ME126220 | FL |
N | 208600000X | Surgeon | ME126220 | FL |
N | 2086S0120X | Pediatric Surgery | 2009-01485 | NC |
N | 2086S0120X | Pediatric Surgery | 25MA07434600 | NJ |
N | 2086S0120X | Pediatric Surgery | MD12370 | RI |
N | 2086S0120X | Pediatric Surgery | ME126220 | FL |
NPI | 1568664589 |
---|---|
Provider Name | Abigail E. Martin |
First Address | Rockland, DE 19732-0191 |
Second Address | Wilmington, DE 19803-3607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2007 |
Last Update Date | 13/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0387258 | (05) | NJ |
102901546 | (05) | PA |
325309100 | (05) | MD |
358075SAJ | MEDICARE (01) | PA |
5912040 | (05) | NC |