Provider Demographics
NPI:1659710283
Name:MARTIN, EVA MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:EVA
Middle Name:MARIE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:EVA
Other - Middle Name:MARIE
Other - Last Name:CANTOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1991 SPROUL RD STE 200
Mailing Address - Street 2:
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-3518
Mailing Address - Country:US
Mailing Address - Phone:610-325-1350
Mailing Address - Fax:610-325-3518
Practice Address - Street 1:1991 SPROUL RD STE 200
Practice Address - Street 2:
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008-3518
Practice Address - Country:US
Practice Address - Phone:610-325-1350
Practice Address - Fax:610-325-3518
Is Sole Proprietor?:No
Enumeration Date:2013-06-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD461512207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology