Provider Demographics
NPI:1467434290
Name:MARTIN, DANIEL CHRISOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:CHRISOPHER
Last Name:MARTIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1115 BOULDERS PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4067
Mailing Address - Country:US
Mailing Address - Phone:804-560-5595
Mailing Address - Fax:804-560-9029
Practice Address - Street 1:7650 E PARHAM RD
Practice Address - Street 2:SUITE 100
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23294-4373
Practice Address - Country:US
Practice Address - Phone:804-288-3136
Practice Address - Fax:804-288-4538
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2020-09-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101040954207LP2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA3140423OtherMAMSI-UNITED HEALTHCARE
VA540885859OtherUNITED HEALTHCARE
VA238673OtherANTHEM
VA1381338OtherAETNA US HMO
VA1467434290Medicaid
VA10012980OtherOPTIMA HEALTH
VA540885859OtherCIGNA
VA442112OtherSOUTHERN HEALTH
VA010316391Medicaid
VA0472640005Medicare NSC
VA442112OtherSOUTHERN HEALTH
VA540885859OtherCIGNA