Provider Demographics
NPI:1942256516
Name:WEBB, MARTIN W (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:W
Last Name:WEBB
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 1:309 NEW ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-3654
Mailing Address - Country:US
Mailing Address - Phone:336-379-9708
Mailing Address - Fax:336-553-2085
Practice Address - Street 1:309 NEW ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-3654
Practice Address - Country:US
Practice Address - Phone:336-379-9708
Practice Address - Fax:336-553-2085
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200200624207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891313FMedicaid
NC1313FOtherBCBS PROVIDER #
NC561274347OtherCKA'S TAX ID #
NC31000066OtherUHC PROVIDER #
NC390008252OtherRRM PROVIDER #
NC1313FOtherBCBS PROVIDER #
NC390008252OtherRRM PROVIDER #