Healthcare Provider Details

I. General information

NPI: 1134166861
Provider Name (Legal Business Name): LEILA M MARTIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 03/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 HOSPITAL DR
HIGHLANDS NC
28741-7600
US

IV. Provider business mailing address

50 SCHENCK PKWY
ASHEVILLE NC
28803-3499
US

V. Phone/Fax

Practice location:
  • Phone: 828-526-1424
  • Fax:
Mailing address:
  • Phone: 828-681-1527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number9700101
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: