Healthcare Provider Details

I. General information

NPI: 1497318497
Provider Name (Legal Business Name): DELMAR JAY MARTIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2019
Last Update Date: 03/15/2024
Certification Date: 03/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9166 N CONGRESS ST
NEW MARKET VA
22844-9422
US

IV. Provider business mailing address

5173 MAIN ST
MOUNT JACKSON VA
22842-9513
US

V. Phone/Fax

Practice location:
  • Phone: 540-459-1340
  • Fax: 540-459-1349
Mailing address:
  • Phone: 540-459-1350
  • Fax: 540-459-1351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0116032514
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: