Martin, Derrick J

Martin, Derrick J is an individual health care provider with primary practice located at 10770 Se 173Rd St , Summerfield FL 34491-6851. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Martin, Derrick J can be contacted via phone (352) 425-7321.

Contact Information

Primary practice address
10770 Se 173Rd St Summerfield FL 34491-6851
Phone: (352) 425-7321
Fax: (352) 748-2700
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X MD205035 Louisiana
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X ME100133 Florida
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X ME100133 Florida

Profile Details

NPI number 1104980812
LBN Legal business name Martin, Derrick J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 20th, 2006
Last updated Sep 21st, 2022 - about 4 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 1104980812 NPPES
Louisiana Other SDW70 CHOICECARE

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