1144230087 NPI number — DR. HAROLD L MARTIN MD

Table of content: DR. HAROLD L MARTIN MD (NPI 1144230087)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144230087 NPI number — DR. HAROLD L MARTIN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MARTIN
Provider First Name:
HAROLD
Provider Middle Name:
L
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144230087
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/15/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
108 ENDO LN
Provider Second Line Business Mailing Address:
SUITE 1
Provider Business Mailing Address City Name:
HAMLET
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28345-4566
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-205-8909
Provider Business Mailing Address Fax Number:
910-205-8952

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
108 ENDO LN
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
HAMLET
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28345-4566
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-205-8909
Provider Business Practice Location Address Fax Number:
910-205-8952
Provider Enumeration Date:
08/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  ME0033154 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208600000X , with the licence number: 2006-01482 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X , with the licence number: 047924 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X , with the licence number: 13989 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X , with the licence number: 10901 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com