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NPI Code Detail

MEDICARE: MARK ANDREW MARTIN MD

MEDICARE: MARK ANDREW 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
1207Q00000XFamily Medicine Physician200100263NC
2207Q00000XFamily Medicine Physician18996SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326032566
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK ANDREW MARTIN MD
Provider Business Mailing Address
First Line : 105 FRANKLIN SQUARE WAY STE A
Second Line :
City : EASLEY
State : SC
Zip : 29642-3715
Country : US
Telephone Number : 864-442-4110
Fax Number : 864-442-4126
Provider Business Practice Location Address
First Line : 105 FRANKLIN SQUARE WAY STE A
Second Line :
City : EASLEY
State : SC
Zip : 29642-3715
Country : US
Telephone Number : 864-442-4110
Fax Number : 864-442-4126
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2005
Last Update Date : 06/28/2023

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