Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 81839 | MA |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | MA81839 | MA |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | MA81839 | MA |
NPI | 1689625642 |
---|---|
Provider Name | Tamara L Martin |
First Address | Chestnut Hill, MA 02467 |
Second Address | Chestnut Hill, MA 02467 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2006 |
Last Update Date | 19/11/2014 |