Provider Demographics
NPI:1376721332
Name:INGRAM, MARTHA (ND)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:
Last Name:INGRAM
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:BREVARD
Mailing Address - State:NC
Mailing Address - Zip Code:28712-3396
Mailing Address - Country:US
Mailing Address - Phone:828-233-5576
Mailing Address - Fax:828-398-0430
Practice Address - Street 1:1 MARKET ST
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-3396
Practice Address - Country:US
Practice Address - Phone:828-233-5576
Practice Address - Fax:828-398-0430
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT099.0062308175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath