Provider Demographics
NPI:1881679397
Name:MARTIN, TROY M (MD)
Entity Type:Individual
Prefix:DR
First Name:TROY
Middle Name:M
Last Name:MARTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 50150
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98015-0150
Mailing Address - Country:US
Mailing Address - Phone:425-228-5228
Mailing Address - Fax:425-228-5733
Practice Address - Street 1:10631 EIGHTH AVENUE NORTHEAST
Practice Address - Street 2:KINDRED HOSPITAL SEATTLE
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125
Practice Address - Country:US
Practice Address - Phone:206-361-7431
Practice Address - Fax:206-361-7452
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-08
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60002235207R00000X, 207RI0200X
RIMD11639207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1881679397Medicaid
RI7057246Medicaid
RI7057246Medicaid