Provider Demographics
NPI:1922375518
Name:MARTIN, TROY MICHAEL (RPH)
Entity Type:Individual
Prefix:MR
First Name:TROY
Middle Name:MICHAEL
Last Name:MARTIN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10595 N MICHIGAN RD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-9685
Mailing Address - Country:US
Mailing Address - Phone:317-872-5498
Mailing Address - Fax:317-872-5513
Practice Address - Street 1:10595 N MICHIGAN RD
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-9685
Practice Address - Country:US
Practice Address - Phone:317-872-5498
Practice Address - Fax:317-872-5513
Is Sole Proprietor?:No
Enumeration Date:2011-11-26
Last Update Date:2011-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26017299A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist