Provider Demographics
NPI:1851395891
Name:TRAN, MARTIN QUAN (DO)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:QUAN
Last Name:TRAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:107 WOODLAWN DR
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-5978
Mailing Address - Country:US
Mailing Address - Phone:423-929-7158
Mailing Address - Fax:423-928-9625
Practice Address - Street 1:107 WOODLAWN DR
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-5978
Practice Address - Country:US
Practice Address - Phone:423-929-7158
Practice Address - Fax:423-928-9625
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2010-01-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNDO1528207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3307966Medicaid
TN3307966Medicaid
TNH90490Medicare UPIN