Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 51248 | MA |
N | 111NI0900X | Internist | 51248 | MA |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 51248 | MA |
NPI | 1053301218 |
---|---|
Provider Name | Dr. Kathryn A Martin |
First Address | Charlestown, MA 02129-9142 |
Second Address | Boston, MA 02114-2696 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
051248 | TUFTS HEALTH PLAN (01) | MA |
3035603 | (05) | MA |
B99162 | (02) | |
J02209 | BCBS MA (01) | MA |