MEDICARE: MARCUS MARTIN

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1932802998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCUS MARTIN

Provider Business Mailing Address
First Line	:	2610 SUMMERWAY CT
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-4886
Country	:	US
Telephone Number	:	319-536-2695
Fax Number	:

Provider Business Practice Location Address
First Line	:	2610 SUMMERWAY CT
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-4886
Country	:	US
Telephone Number	:	319-536-2695
Fax Number	:

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

Provider Enumeration Date	:	03/27/2023
Last Update Date	:	03/27/2023

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Directions to “ MARCUS MARTIN ” Practice Location

Language	Start Address	Practice Location

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