Healthcare Provider Details

I. General information

NPI: 1871685370
Provider Name (Legal Business Name): CHRISTINE LOUISE MARTIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13200 STRICKLAND RD STE 120
RALEIGH NC
27613-5212
US

IV. Provider business mailing address

13200 STRICKLAND RD STE 120
RALEIGH NC
27613-5212
US

V. Phone/Fax

Practice location:
  • Phone: 919-391-9430
  • Fax:
Mailing address:
  • Phone: 919-391-9430
  • Fax: 855-861-0602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number92861
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2024-02643
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: