Provider Demographics
NPI:1184208316
Name:MARTIN, ERIN E (PA)
Entity Type:Individual
Prefix:MISS
First Name:ERIN
Middle Name:E
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5671 PEACHTREE DUNWOODY RD STE 900
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-5022
Mailing Address - Country:US
Mailing Address - Phone:404-847-9999
Mailing Address - Fax:
Practice Address - Street 1:5671 PEACHTREE DUNWOODY RD STE 900
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-5022
Practice Address - Country:US
Practice Address - Phone:404-847-9999
Practice Address - Fax:404-531-8466
Is Sole Proprietor?:No
Enumeration Date:2021-05-12
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA10476363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant