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General NPI Number Information
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NPI Number | 1225010143
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Entity Type | Individual
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Provider Name | PIERRE THOMAS MARTIN MD
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Gender | Male
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Dates
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Enumeration Date | 11/16/2005
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Last Update Date | 03/29/2023
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Provider Practice Location Address
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Address Line | 5818 HARBOUR VIEW BLVD SUITE 230
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City | SUFFOLK
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State | VA
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Zip | 23435-3315
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Country | US
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Telephone | 757-673-6118
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Fax | 757-967-9003
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Provider Business Mailing Address
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Address Line | 860 OMNI BLVD STE 128
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-4430
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Country | US
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Telephone | 757-232-8769
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Fax | 757-232-8875
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 0101240884
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License Number State | VA
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