Provider Demographics
NPI:1962848200
Name:MARTIN, CHARLES DEE (DO)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:DEE
Last Name:MARTIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:FAMILY MEDICINE RESIDENCY NH PENSACOLA
Mailing Address - Street 2:6000 W. HWY 98
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32512-0001
Mailing Address - Country:US
Mailing Address - Phone:850-505-6472
Mailing Address - Fax:
Practice Address - Street 1:FAMILY MEDICINE RESIDENCY NH PENSACOLA
Practice Address - Street 2:6000 W. HWY 98
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32512-0001
Practice Address - Country:US
Practice Address - Phone:850-505-6472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program