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General NPI Number Information
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NPI Number | 1427685452
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Entity Type | Individual
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Provider Name | NICHOLAS ROBERT MARTIN MD
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Gender | Male
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Dates
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Enumeration Date | 03/27/2020
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 1565 N MAIN ST
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City | FALL RIVER
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State | MA
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Zip | 02720-2972
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Country | US
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Telephone | 508-973-2211
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Fax | 508-973-9885
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Provider Business Mailing Address
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Address Line | 200 MILL RD
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City | FAIRHAVEN
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State | MA
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Zip | 02719-5252
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Country | US
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Telephone | 508-973-2211
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Fax | 508-973-9885
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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 | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 292897
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License Number State | MA
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