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General NPI Number Information
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NPI Number | 1871836601
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Entity Type | Individual
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Provider Name | SCOTT MICHAEL MARTIN DPM
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Gender | Male
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Dates
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Enumeration Date | 03/29/2013
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 3301 SUNSET AVE
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City | ROCKY MOUNT
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State | NC
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Zip | 27804-3521
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Country | US
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Telephone | 252-443-7114
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Fax | 252-443-7115
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Provider Business Mailing Address
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Address Line | 3301 SUNSET AVE
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City | ROCKY MOUNT
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State | NC
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Zip | 27804-3521
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Country | US
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Telephone | 252-443-7114
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Fax | 252-443-7115
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 634
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 634
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License Number State | NC
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