Provider Demographics
NPI:1952397184
Name:MARTIN, WILLIAM STANLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:STANLEY
Last Name:MARTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8590 POTTER PARK DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34238-5440
Mailing Address - Country:US
Mailing Address - Phone:941-921-6618
Mailing Address - Fax:941-922-0556
Practice Address - Street 1:8590 POTTER PARK DR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34238-5440
Practice Address - Country:US
Practice Address - Phone:941-921-6618
Practice Address - Fax:941-922-0556
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME127407207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY201293Medicare PIN
NYF21025Medicare UPIN