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NPI Code Detail

MEDICARE: MARTIN TYLER DEAL M.D.

MEDICARE:   MARTIN TYLER DEAL  M.D.
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
1207R00000XInternal Medicine Physician9701734NC
2207R00000XInternal Medicine Physician0101056743VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11104WOTHERNCBCBS INDIVIDUAL NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285627786
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARTIN TYLER DEAL M.D.
Provider Business Mailing Address
First Line : 946 N MAIN ST
Second Line :
City : CHASE CITY
State : VA
Zip : 23924-1139
Country : US
Telephone Number : 434-372-5141
Fax Number : 434-372-8910
Provider Business Practice Location Address
First Line : 946 N MAIN ST
Second Line :
City : CHASE CITY
State : VA
Zip : 23924-1139
Country : US
Telephone Number : 434-372-5141
Fax Number : 434-372-8910
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2005
Last Update Date : 01/07/2022

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Directions to “ MARTIN TYLER DEAL M.D.” Practice Location

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