Provider Demographics
NPI:1528209335
Name:MARTIN, JONATHAN HAMILTON (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:HAMILTON
Last Name:MARTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1407 S COUNTY TRL STE 431
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-1679
Mailing Address - Country:US
Mailing Address - Phone:401-398-0288
Mailing Address - Fax:401-471-7365
Practice Address - Street 1:1407 S COUNTY TRL STE 431
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-1679
Practice Address - Country:US
Practice Address - Phone:401-398-0288
Practice Address - Fax:401-471-7365
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-09
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD13449207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine