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General NPI Number Information
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NPI Number | 1114955192
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Entity Type | Individual
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Provider Name | MICHAEL JOSEPH MARTIN CHIROPRACTOR
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Gender | Male
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 03/14/2012
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Provider Practice Location Address
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Address Line | 7839 WISE AVE
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City | BALTIMORE
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State | MD
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Zip | 21222-3339
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Country | US
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Telephone | 410-288-1800
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Fax | 410-288-1818
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Provider Business Mailing Address
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Address Line | 7839 WISE AVE
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City | BALTIMORE
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State | MD
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Zip | 21222-3339
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Country | US
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Telephone | 410-288-1800
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Fax | 410-288-1818
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 01387
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3485
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License Number State | PA
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