Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | 82767 | GA |
NPI | 1205253390 |
---|---|
Provider Name | Dr. Morgan Sparks Martin |
First Address | Atlanta, GA 30322-1059 |
Second Address | Atlanta, GA 30322-2360 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2014 |
Last Update Date | 08/05/2019 |