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NPI Code Detail

MEDICARE: DR. MARK G MARTENS MD

MEDICARE: DR. MARK G MARTENS 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
1207V00000XObstetrics & Gynecology PhysicianMD464152PA
2207V00000XObstetrics & Gynecology Physician25MA08692100NJ
3207V00000XObstetrics & Gynecology Physician320910NY

General Provider Information

NPI Number : 1447221510
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK G MARTENS MD
Provider Business Mailing Address
First Line : 17 LANSING ST
Second Line :
City : AUBURN
State : NY
Zip : 13021-1983
Country : US
Telephone Number : 315-255-7011
Fax Number : 315-255-7099
Provider Business Practice Location Address
First Line : 143 NORTH ST STE 2
Second Line :
City : AUBURN
State : NY
Zip : 13021-1983
Country : US
Telephone Number : 315-252-5028
Fax Number : 315-252-1587
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2006
Last Update Date : 02/13/2025

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