Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | MD038811E | PA |
N | 207QA0401X | Family Doctor - Addiction Medicine | MD038811E | PA |
NPI | 1215910542 |
---|---|
Provider Name | Ronald Christian Martin |
First Address | Cambridge Springs, PA 16403-1060 |
Second Address | Cambridge Springs, PA 16403-1060 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2005 |
Last Update Date | 08/07/2007 |