Provider Demographics
NPI:1821809096
Name:MARTIN, LOUIS CHARLES III
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:CHARLES
Last Name:MARTIN
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3135 E 99TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44104-5322
Mailing Address - Country:US
Mailing Address - Phone:216-402-1792
Mailing Address - Fax:
Practice Address - Street 1:3135 E 99TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44104-5322
Practice Address - Country:US
Practice Address - Phone:216-402-1792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health