Martin, Mary Ellen
Martin, Mary Ellen is an individual health care provider with primary practice located at 3400 Civic Center Blvd, South Pavilion, 12Th Floor Perelman Center For Advanced Medicine, Philadelphia PA 19104. She recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as her primary health care specialty. Martin, Mary Ellen can be contacted via phone (215) 360-0713.Contact Information
Primary practice address
3400 Civic Center Blvd, South Pavilion, 12Th Floor Perelman Center For Advanced Medicine
Philadelphia PA 19104
Phone: (215) 360-0713
Fax: (215) 214-3779
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hematology & Oncology | 207RH0003X | MD-068066-L | Pennsylvania |
| Allopathic & Osteopathic Physicians / Hematology & Oncology | 207RH0003X | MD068066L | Pennsylvania |
Profile Details
| NPI number | 1922096031 |
|---|---|
| LBN Legal business name | Martin, Mary Ellen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 12th, 2005 |
| Last updated | Nov 3rd, 2016 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1922096031 | NPPES |
| Pennsylvania | MEDICAID | 00189880400001 |
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