Provider Demographics
NPI:1013193374
Name:ANGELA M. MARTIN, M.D. F.A.A.P.
Entity Type:Organization
Organization Name:ANGELA M. MARTIN, M.D. F.A.A.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-237-1184
Mailing Address - Street 1:222 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-5706
Mailing Address - Country:US
Mailing Address - Phone:256-237-1184
Mailing Address - Fax:256-237-8400
Practice Address - Street 1:222 E 10TH ST
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-5706
Practice Address - Country:US
Practice Address - Phone:256-237-1184
Practice Address - Fax:256-237-8400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-17
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13331208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty