Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 39021 | NC |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 39021 | NC |
NPI | 1003890070 |
---|---|
Provider Name | David Franklin Martin |
First Address | Winston Salem, NC 27102-0344 |
Second Address | Winston Salem, NC 27157-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2005 |
Last Update Date | 15/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
205337000 | (05) | WV |
4160 | PARTNERS (01) | NC |
54147 | BCBS (01) | NC |
5621093 | AETNA (01) | |
64229 | MEDCOST (01) | NC |
6455581 | (05) | VA |
8954147 | (05) | NC |
C75442 | (02) | |
Q39021 | (05) | SC |