Martin, David E
Martin, David E is an individual health care provider with primary practice located at 845 W Center St Suite 200, Pocatello ID 83204-4205. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Martin, David E can be contacted via phone (208) 232-6260.Contact Information
Primary practice address
845 W Center St Suite 200
Pocatello ID 83204-4205
Phone: (208) 232-6260
Fax: (208) 232-6259
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA39 | Idaho |
Profile Details
NPI number | 1215929690 |
---|---|
LBN Legal business name | Martin, David E |
Credentials | Physician's Assistant Certified (PA-C) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Aug 22nd, 2005 |
Last updated | Jul 9th, 2007 - about 17 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1215929690 | NPPES |
Idaho | MEDICAID | 0021913 | |
Idaho | Other | 000010151329 | |
Idaho | Other | PANR7 |
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