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General NPI Number Information
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NPI Number | 1215910344
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Entity Type | Individual
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Provider Name | CAROL ANN MARTIN MD
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Gender | Female
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Dates
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Enumeration Date | 11/22/2005
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Last Update Date | 05/05/2008
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Provider Practice Location Address
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Address Line | 1220 SE MAYNARD RD STE 102
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City | CARY
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State | NC
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Zip | 27511
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Country | US
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Telephone | 919-462-1440
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Fax | 919-462-1448
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Provider Business Mailing Address
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Address Line | 1220 SE MAYNARD RD STE 102
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City | CARY
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State | NC
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Zip | 27511-6944
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Country | US
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Telephone | 919-462-1440
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Fax | 919-462-1448
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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 | 9901651
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License Number State | NC
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