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General NPI Number Information
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NPI Number | 1992471601
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Entity Type | Individual
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Provider Name | SEBASTIAN MAURICIO MARTENS PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/22/2021
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Last Update Date | 02/13/2023
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Provider Practice Location Address
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Address Line | 4408 NEW BERN AVE
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City | RALEIGH
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State | NC
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Zip | 27610-1444
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Country | US
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Telephone | 919-231-6419
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Fax |
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Provider Business Mailing Address
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Address Line | 640 S ELLIOTT RD APT 314
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City | CHAPEL HILL
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State | NC
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Zip | 27517-2624
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Country | US
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Telephone | 305-335-2427
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 63042
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 31721
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License Number State | NC
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