Martin, David E

Martin, David E is an individual health care provider with primary practice located at 845 W Center St Suite 200, Pocatello ID 83204-4205. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Martin, David E can be contacted via phone (208) 232-6260.

Contact Information

Primary practice address
845 W Center St Suite 200 Pocatello ID 83204-4205
Phone: (208) 232-6260
Fax: (208) 232-6259
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA39 Idaho

Profile Details

NPI number 1215929690
LBN Legal business name Martin, David E
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 22nd, 2005
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215929690 NPPES
Idaho MEDICAID 0021913
Idaho Other 000010151329
Idaho Other PANR7

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