Provider Demographics
NPI:1285828905
Name:MARTIN, JAMIE DARHL
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:DARHL
Last Name:MARTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:DARHL
Other - Last Name:TANNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1430 DELAWARE AVE APT A
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08204-4038
Mailing Address - Country:US
Mailing Address - Phone:124-220-7080
Mailing Address - Fax:
Practice Address - Street 1:1 MUNRO AVE
Practice Address - Street 2:
Practice Address - City:CAPE MAY
Practice Address - State:NJ
Practice Address - Zip Code:08204-5000
Practice Address - Country:US
Practice Address - Phone:609-898-6610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other