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NPI Code Detail

MEDICARE: MR. STEPHEN A MARTIN

MEDICARE: MR. STEPHEN A MARTIN
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
11835P1200XPharmacotherapy Pharmacist10109NC

General Provider Information

NPI Number : 1689650681
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. STEPHEN A MARTIN
Provider Business Mailing Address
First Line : 202 BARKER TEN MILE RD
Second Line :
City : LUMBERTON
State : NC
Zip : 28358-5883
Country : US
Telephone Number : 910-671-5719
Fax Number : 910-671-5709
Provider Business Practice Location Address
First Line : 1150 PINE RUN DR
Second Line :
City : LUMBERTON
State : NC
Zip : 28358-2118
Country : US
Telephone Number : 910-671-5719
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2005
Last Update Date : 07/08/2007

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Directions to “ MR. STEPHEN A MARTIN ” Practice Location

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