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NPI Code Detail

MEDICARE: PAMELA C MARTIN MD

MEDICARE: PAMELA C MARTIN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZD0900XDermatopathology (Pathology) PhysicianL015176LA
2207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianL015176LA
3207ZD0900XDermatopathology (Pathology) PhysicianMD015176LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215929922
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAMELA C MARTIN MD
Provider Business Mailing Address
First Line : 5700 SOUTHWYCK BLVD
Second Line :
City : TOLEDO
State : OH
Zip : 43614-1509
Country : US
Telephone Number : 800-288-8325
Fax Number : 419-866-5453
Provider Business Practice Location Address
First Line : 1401 FOUCHER STREET
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70115-3515
Country : US
Telephone Number : 504-897-8418
Fax Number : 419-866-5453
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2005
Last Update Date : 02/25/2015

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Directions to “ PAMELA C MARTIN MD” Practice Location

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