Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 253266 | MA |
NPI | 1013178094 |
---|---|
Provider Name | Melissa A Martin |
First Address | Woburn, MA 01801-6372 |
Second Address | Woburn, MA 01801-6372 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2008 |
Last Update Date | 13/04/2018 |