MEDICARE: MS. KARA M 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
1	207RR0500X	Rheumatology Physician	9600629	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	2225603	OTHER	NC	MEDICARE PTAN END DATE 2/25/2009
5	2225603B	OTHER	NC	MEDICARE PTAN START DATE 2/26/2009
6	660001954	OTHER	NC	MEDICARE RAILROAD PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	54479	OTHER	NC	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881691277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KARA M MARTIN MD

Provider Business Mailing Address
First Line	:	4204 MURDOCKSVILLE ROAD
Second Line	:
City	:	WEST END
State	:	NC
Zip	:	27376-8871
Country	:	US
Telephone Number	:	910-255-0055
Fax Number	:	910-255-0060

Provider Business Practice Location Address
First Line	:	4204 MURDOCKSVILLE ROAD
Second Line	:
City	:	WEST END
State	:	NC
Zip	:	27376-8871
Country	:	US
Telephone Number	:	910-255-0055
Fax Number	:	910-255-0060

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

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	06/23/2016

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Directions to “ MS. KARA M MARTIN MD” Practice Location

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