Provider Demographics
NPI:1932134434
Name:ISER, MARTIN (MD)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:
Last Name:ISER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:795 BRIDGE STREET
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02191
Mailing Address - Country:US
Mailing Address - Phone:781-337-4105
Mailing Address - Fax:781-337-6239
Practice Address - Street 1:795 BRIDGE STREET
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02191
Practice Address - Country:US
Practice Address - Phone:781-337-4105
Practice Address - Fax:781-337-6239
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA43429207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6187625Medicaid
A57169Medicare UPIN
MA6187625Medicaid