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General NPI Number Information
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NPI Number | 1861543696
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Entity Type | Organization
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Legal Business Name | JEFFREY E MARTIN MD
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 05/26/2008
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Provider Practice Location Address
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Address Line | 744 ROOSEVELT TRL
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City | WINDHAM
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State | ME
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Zip | 04062-5282
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Country | US
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Telephone | 207-892-7055
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Fax | 207-893-1215
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Provider Business Mailing Address
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Address Line | 4 SCAMMAN ST SUITE 19 PMB 2700
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City | SACO
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State | ME
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Zip | 04072
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Country | US
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Telephone | 207-892-7055
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Fax | 207-893-1215
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Authorized Official
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Title or Position | OWNER AND PROVIDER
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Name | JEFFREY E MARTIN
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Credential | MD
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Telephone | 207-892-7055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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