Provider Demographics
NPI:1730493313
Name:MARTENS, DANIEL C (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:C
Last Name:MARTENS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:US ARMY MEDICAL DEPARTMENT ACTIVITY
Mailing Address - Street 2:UNIT 15244, APO, AP
Mailing Address - City:NA
Mailing Address - State:NA
Mailing Address - Zip Code:96205 5244
Mailing Address - Country:KR
Mailing Address - Phone:315-737-6123
Mailing Address - Fax:
Practice Address - Street 1:US ARMY MEDICAL DEPARTMENT ACTIVITY
Practice Address - Street 2:UNIT 15244, APO, AP
Practice Address - City:NA
Practice Address - State:NA
Practice Address - Zip Code:96205 5244
Practice Address - Country:KR
Practice Address - Phone:315-737-6123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant