MEDICARE: DANIEL S 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
1	207Q00000X	Family Medicine Physician	MD417368	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	080189416	OTHER		RAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1598767816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL S MARTIN MD

Provider Business Mailing Address
First Line	:	9 N BROOKSIDE RD
Second Line	:
City	:	SPRINGFIELD
State	:	PA
Zip	:	19064-2527
Country	:	US
Telephone Number	:	610-543-5400
Fax Number	:	610-543-3124

Provider Business Practice Location Address
First Line	:	9 N BROOKSIDE RD
Second Line	:
City	:	SPRINGFIELD
State	:	PA
Zip	:	19064-2527
Country	:	US
Telephone Number	:	610-543-5300
Fax Number	:	610-543-3124

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

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	02/08/2022

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Directions to “ DANIEL S MARTIN MD” Practice Location

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