Martin, Derrick J
Martin, Derrick J is an individual health care provider with primary practice located at 10770 Se 173Rd St , Summerfield FL 34491-6851. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Martin, Derrick J can be contacted via phone (352) 425-7321.Contact Information
Primary practice address
10770 Se 173Rd St
Summerfield FL 34491-6851
Phone: (352) 425-7321
Fax: (352) 748-2700
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | MD205035 | Louisiana |
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | ME100133 | Florida |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ME100133 | Florida |
Profile Details
| NPI number | 1104980812 |
|---|---|
| LBN Legal business name | Martin, Derrick J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 20th, 2006 |
| Last updated | Sep 21st, 2022 - about 2 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 | 1104980812 | NPPES |
| Louisiana | Other | SDW70 | CHOICECARE |
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