Provider Demographics
NPI:1659362408
Name:MARTIN, BENJAMIN FREDRIC (MD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:FREDRIC
Last Name:MARTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 HOT METAL ST
Mailing Address - Street 2:QUANTUM ONE
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203-2348
Mailing Address - Country:US
Mailing Address - Phone:412-432-7400
Mailing Address - Fax:412-432-7789
Practice Address - Street 1:815 FREEPORT RD
Practice Address - Street 2:UPMC ST. MARGARET
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15215-3301
Practice Address - Country:US
Practice Address - Phone:412-784-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD069083L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD069083LOtherMEDICAL LIC NUMBER
PAMD069083LOtherMEDICAL LIC NUMBER
PAMD069083LOtherMEDICAL LIC NUMBER
OHH036270Medicare PIN