Provider Demographics
NPI:1720389885
Name:MARTIN, CHRISTOPHER WILFRED
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:WILFRED
Last Name:MARTIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 PEBBLE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30014-4400
Mailing Address - Country:US
Mailing Address - Phone:404-992-4031
Mailing Address - Fax:
Practice Address - Street 1:135 PEBBLE RIDGE DR
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-4400
Practice Address - Country:US
Practice Address - Phone:404-992-4031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No374J00000XNursing Service Related ProvidersDoula
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide