Doctor Name: | ALLEN MARTIN |
NPI Number: | 1679696843 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 25MA03465400 |
Business Practice Address: | 39 Brace Rd Cherry Hill, NJ - 080342624 |
Business Phone Number: | 8563545133 |
Business Fax Number: | 6095893947 |
Mailing Address: | 39 Brace Rd, CHERRY HILL |
State: | NJ |
Postal Code: | 080342624 |
Phone Number: | 8563545133 |
Fax Number: | 6095893947 |
NPI Enumeration Date: | 04/10/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 25MA03465400 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |