MEDICARE: WILLIAM F MARTIN MSW

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
1	1041C0700X	Clinical Social Worker	CW022358	PA
2	1041C0700X	Clinical Social Worker	149-003694	IL

General Provider Information

NPI Number	:	1710072244
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM F MARTIN MSW

Provider Business Mailing Address
First Line	:	2206 E ALBERT ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19125-1805
Country	:	US
Telephone Number	:	739-363-6077
Fax Number	:	844-355-2174

Provider Business Practice Location Address
First Line	:	2206 E ALBERT ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19125-1805
Country	:	US
Telephone Number	:	739-363-6077
Fax Number	:	844-355-2174

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	12/31/2024

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