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1619282290 NPI number — SEAN MARTIN

NPI Number: 1619282290
Health Care Provider/Practitioner: SEAN MARTIN

Information about “1619282290” NPI (SEAN MARTIN) exists in 1619282290 in HTML format HTML  |  1619282290 in plain Text format TXT  |  1619282290 in PDF (Portable Document Format) PDF  |  1619282290 in an XML format XML  formats.

NPI Number : 1619282290 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1619282290",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MARTIN",
    "FirstName": "SEAN",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MARTIN",
    "OtherFirstName": "JOHN",
    "OtherMiddleName": null,
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": "M.D.",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "2460 OVERLOOK RD",
    "SecondLineMailingAddress": "APARTMENT 4",
    "MailingAddressCityName": "CLEVELAND",
    "MailingAddressStateName": "OH",
    "MailingAddressPostalCode": "44106-2456",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "216-970-2294",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1924 E 86TH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CLEVELAND",
    "PracticeLocationAddressStateName": "OH",
    "PracticeLocationAddressPostalCode": "44106-2021",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "216-970-2294",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/08/2010",
    "LastUpdateDate": "10/10/2011",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "208C00000X",
        "TaxonomyName": "Colon & Rectal Surgery Physician",
        "LicenseNumber": "098010",
        "LicenseNumberStateCode": "OH",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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