Provider Demographics
NPI:1689776361
Name:MARTIN, WENDY MAYER (MD)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:MAYER
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:ANN
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2824
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03302
Mailing Address - Country:US
Mailing Address - Phone:781-744-8013
Mailing Address - Fax:781-744-5235
Practice Address - Street 1:121 SOUTH FRUIT STREET
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301
Practice Address - Country:US
Practice Address - Phone:603-271-5994
Practice Address - Fax:781-744-5235
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2565912084P0800X
NH135512084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry