Provider Demographics
NPI:1710084330
Name:DENKER, MARTIN WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:WILLIAM
Last Name:DENKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2177 LOCKHART RD
Mailing Address - Street 2:M. W. DENKER, M.D., P.A.
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34602-6208
Mailing Address - Country:US
Mailing Address - Phone:352-650-6978
Mailing Address - Fax:352-583-5263
Practice Address - Street 1:12128 CORTEZ BLVD
Practice Address - Street 2:WELLSPRING COUNSELING CENTER
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34613-5575
Practice Address - Country:US
Practice Address - Phone:352-592-7740
Practice Address - Fax:352-592-7742
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME00194342084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL29683OtherBC/BS PROVIDER NUMBER
FL039766100Medicaid
FL29683OtherBC/BS PROVIDER NUMBER
FL039766100Medicaid