Provider Demographics
NPI:1457403354
Name:MARTIN, DAVID D (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:D
Last Name:MARTIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7010 NC HIGHWAY 751
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-5733
Mailing Address - Country:US
Mailing Address - Phone:919-794-4455
Mailing Address - Fax:
Practice Address - Street 1:7010 NC HIGHWAY 751
Practice Address - Street 2:SUITE 102
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-5733
Practice Address - Country:US
Practice Address - Phone:919-794-4455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2015-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0098261111N00000X
PADC007773L111N00000X
NC4436111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400047523Medicare PIN
NYCC4371Medicare ID - Type Unspecified