Provider Demographics
NPI:1134723752
Name:MARTIN, DARIAN JAMES (MED)
Entity type:Individual
Prefix:MR
First Name:DARIAN
Middle Name:JAMES
Last Name:MARTIN
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:869 MAIN ST STE 6B
Mailing Address - Street 2:
Mailing Address - City:WALPOLE
Mailing Address - State:MA
Mailing Address - Zip Code:02081-2985
Mailing Address - Country:US
Mailing Address - Phone:407-342-9380
Mailing Address - Fax:
Practice Address - Street 1:869 MAIN ST STE 6B
Practice Address - Street 2:
Practice Address - City:WALPOLE
Practice Address - State:MA
Practice Address - Zip Code:02081-2985
Practice Address - Country:US
Practice Address - Phone:617-431-4308
Practice Address - Fax:781-327-2703
Is Sole Proprietor?:No
Enumeration Date:2020-11-24
Last Update Date:2024-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program