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General NPI Number Information
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NPI Number | 1154348787
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Entity Type | Individual
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Provider Name | MIRIAM DALTON MARTIN M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 200 HOSPITAL DR
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City | GALAX
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State | VA
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Zip | 24333-2227
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Country | US
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Telephone | 276-236-8181
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Fax | 540-236-1715
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Provider Business Mailing Address
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Address Line | 200 CORPORATE BLVD
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City | LAFAYETTE
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State | LA
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Zip | 70508-3870
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Country | US
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Telephone | 800-893-9698
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 0101235041
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | D0040898
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 35C.003230
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | D40898
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License Number State | MD
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