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General NPI Number Information
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NPI Number | 1013193374
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Entity Type | Organization
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Legal Business Name | ANGELA M. MARTIN, M.D. F.A.A.P.
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Dates
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Enumeration Date | 01/17/2008
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Last Update Date | 01/17/2008
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Provider Practice Location Address
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Address Line | 222 E 10TH ST
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City | ANNISTON
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State | AL
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Zip | 36207-5706
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Country | US
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Telephone | 256-237-1184
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Fax | 256-237-8400
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Provider Business Mailing Address
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Address Line | 222 E 10TH ST
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City | ANNISTON
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State | AL
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Zip | 36207-5706
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Country | US
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Telephone | 256-237-1184
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Fax | 256-237-8400
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANGELA M. MARTIN
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Credential | M.D.
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Telephone | 256-237-1184
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 13331
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License Number State | AL
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