Provider Demographics
NPI:1952989113
Name:MARTIN, SHEMIKA AMANDA (MD)
Entity type:Individual
Prefix:
First Name:SHEMIKA
Middle Name:AMANDA
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3 UNIVERSITY PLZ STE 205
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-6208
Mailing Address - Country:US
Mailing Address - Phone:201-833-3599
Mailing Address - Fax:201-227-6207
Practice Address - Street 1:30 W CENTURY RD STE 210
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-1440
Practice Address - Country:US
Practice Address - Phone:201-632-5057
Practice Address - Fax:201-483-9201
Is Sole Proprietor?:No
Enumeration Date:2021-03-30
Last Update Date:2024-11-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA12096700207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine