Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251E1200X | Ergonomics | 17674 | MD |
N | 225XE1200X | Ergonomics | 17674 | MD |
N | 2251E1200X | Ergonomics | J10000966 | DE |
N | 225XE1200X | Ergonomics | J10000966 | DE |
Y | 2251X0800X | Physical Therapist - Orthopedic | 17674 | MD |
N | 2251X0800X | Physical Therapist - Orthopedic | J10000966 | DE |
NPI | 1689671067 |
---|---|
Provider Name | Mr. Stephen Edward Martin |
First Address | Snow Hill, MD 21863-1054 |
Second Address | Snow Hill, MD 21863-1054 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2005 |
Last Update Date | 26/11/2015 |