Provider Demographics
NPI:1477698462
Name:LITTLE, MARTHA C (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:C
Last Name:LITTLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 TOOKANY CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:CHELTENHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19012-1107
Mailing Address - Country:US
Mailing Address - Phone:215-635-0860
Mailing Address - Fax:215-635-1719
Practice Address - Street 1:123 TOOKANY CREEK PKWY
Practice Address - Street 2:
Practice Address - City:CHELTENHAM
Practice Address - State:PA
Practice Address - Zip Code:19012-1107
Practice Address - Country:US
Practice Address - Phone:215-635-0860
Practice Address - Fax:215-635-1719
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD046077L2084P0805X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA562314527OtherTAX ID
PAMD046077LOtherMEDICAL LISENCE