Crenshaw, Martha H

Crenshaw, Martha H is an individual health care provider with primary practice located at 1805 Parke Plaza Cir Suite 101, Stone Mountain GA 30087-3498. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Crenshaw, Martha H can be contacted via phone (770) 469-7000.

Contact Information

Primary practice address
1805 Parke Plaza Cir Suite 101 Stone Mountain GA 30087-3498
Phone: (770) 469-7000
Fax: (770) 879-0436
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 023580 Georgia

Profile Details

NPI number 1255325536
LBN Legal business name Crenshaw, Martha H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 1st, 2005
Last updated Feb 17th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255325536 NPPES
Georgia MEDICAID 00247024A1
Georgia Other 0528626
Georgia Other 080027160
Georgia Other 151302

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