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General NPI Number Information
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NPI Number | 1033552856
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Entity Type | Individual
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Provider Name | TODD MARTIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/10/2013
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Last Update Date | 10/09/2020
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Provider Practice Location Address
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Address Line | 211 COUNTY HOUSE RD
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City | SEWELL
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State | NJ
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Zip | 08080-2525
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Country | US
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Telephone | 215-823-5800
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Fax | 877-823-5230
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Provider Business Mailing Address
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Address Line | 833 CHESTNUT ST SUITE 210
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4414
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Country | US
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Telephone | 215-955-9823
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Fax | 215-503-6116
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD455454
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License Number State | PA
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