Provider Demographics
NPI:1851388276
Name:MARTIN, DAVID A (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:MARTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:PO BOX 2699
Mailing Address - Street 2:ATTN: SHMG/HPE
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32513-2699
Mailing Address - Country:US
Mailing Address - Phone:850-278-3742
Mailing Address - Fax:850-278-3428
Practice Address - Street 1:7720 US HIGHWAY 98 W
Practice Address - Street 2:STE 230
Practice Address - City:MIRAMAR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32550-7230
Practice Address - Country:US
Practice Address - Phone:850-278-3742
Practice Address - Fax:850-278-3428
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME122736207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL8ELU1OtherBCBS
OHA47758Medicare UPIN
OH0495541Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER