Provider Demographics
NPI:1073991147
Name:DAVID, MARTIN CLAUDE (LICENSED DME PROVIDE)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:CLAUDE
Last Name:DAVID
Suffix:
Gender:M
Credentials:LICENSED DME PROVIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15029 N THOMPSON PEAK PKWY
Mailing Address - Street 2:B111-580
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2217
Mailing Address - Country:US
Mailing Address - Phone:602-653-1378
Mailing Address - Fax:602-532-7628
Practice Address - Street 1:15029 N THOMPSON PEAK PKWY
Practice Address - Street 2:B111-580
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2217
Practice Address - Country:US
Practice Address - Phone:602-653-1378
Practice Address - Fax:602-532-7628
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-11
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZCR12171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications