MEDICARE: MICHAEL JOSEPH MARTIN CHIROPRACTOR

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
1	111N00000X	Chiropractor	01387	MD
2	111N00000X	Chiropractor	3485	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	M494	OTHER	MD	CAREFIRST BLUE CROSS
2	W2960001	OTHER	MD	CAREFIRST BLUE CHOICE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114955192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL JOSEPH MARTIN CHIROPRACTOR

Provider Business Mailing Address
First Line	:	7839 WISE AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21222-3339
Country	:	US
Telephone Number	:	410-288-1800
Fax Number	:	410-288-1818

Provider Business Practice Location Address
First Line	:	7839 WISE AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21222-3339
Country	:	US
Telephone Number	:	410-288-1800
Fax Number	:	410-288-1818

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	03/14/2012

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Directions to “ MICHAEL JOSEPH MARTIN CHIROPRACTOR” Practice Location

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