Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PE0004X | Emergency Medical Services | 0101260913 | VA |
N | 207PE0004X | Emergency Medical Services | 54888 | TN |
N | 207PE0004X | Emergency Medical Services | MD2021-0064 | NM |
Y | 207PE0004X | Emergency Medical Services | R7531 | TX |
N | 207QA0401X | Family Doctor - Addiction Medicine | 0101260913 | VA |
N | 207QA0401X | Family Doctor - Addiction Medicine | 54888 | TN |
N | 207QA0401X | Family Doctor - Addiction Medicine | MD2021-0064 | NM |
NPI | 1013302900 |
---|---|
Provider Name | Dr. Joseph Michael Martin |
First Address | San Antonio, TX 78210-3801 |
Second Address | San Antonio, TX 78210-3801 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2015 |
Last Update Date | 13/06/2021 |