Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | PO 0002502 | FL |
NPI | 1245238948 |
---|---|
Provider Name | Dr. David Christopher Martin |
First Address | St Petersburg, FL 33716-1820 |
Second Address | St Petersburg, FL 33716-1820 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2005 |
Last Update Date | 21/12/2009 |