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General NPI Number Information
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NPI Number | 1184821662
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Entity Type | Individual
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Provider Name | CAROLINE COKER MARTIN MD, MS
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Gender | Female
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Dates
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Enumeration Date | 06/28/2007
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Last Update Date | 07/19/2013
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Provider Practice Location Address
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Address Line | 1201 BROAD ROCK BLVD DEPARTMENT OF PATHOLOGY AND LABORATORY SERVICES
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City | RICHMOND
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State | VA
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Zip | 23224-4915
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Country | US
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Telephone | 804-675-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 1340 WINSLOW RD
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23235-4158
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Country | US
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Telephone |
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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 | 207ZH0000X
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Taxonomy Name | Hematology (Pathology) Physician
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License Number | 0101246866
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License Number State | VA
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