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NPI Code Detail

MEDICARE: SANDRA B MARTIN MD

MEDICARE: SANDRA B MARTIN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist19374AL

General Provider Information

NPI Number : 1043215114
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDRA B MARTIN MD
Provider Business Mailing Address
First Line : 502 MONTGOMERY HWY
Second Line : STE 101
City : BIRMINGHAM
State : AL
Zip : 35216-1862
Country : US
Telephone Number : 205-823-0882
Fax Number : 205-823-0872
Provider Business Practice Location Address
First Line : 315 W HICKORY ST
Second Line :
City : SYLACAUGA
State : AL
Zip : 35150-2913
Country : US
Telephone Number : 256-249-5000
Fax Number : 256-249-5079
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2005
Last Update Date : 07/24/2007

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Directions to “ SANDRA B MARTIN MD” Practice Location

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