Healthcare Provider Details

I. General information

NPI: 1831382589
Provider Name (Legal Business Name): JEMMA CHARITY L. MARTIRES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2007
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 CHILDRENS LN
NORFOLK VA
23507-1910
US

IV. Provider business mailing address

9532 26TH BAY ST
NORFOLK VA
23518-1814
US

V. Phone/Fax

Practice location:
  • Phone: 757-668-7874
  • Fax:
Mailing address:
  • Phone: 619-606-6376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA97810
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number0101242795
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: