Martin, Niels Douglas
Martin, Niels Douglas is an individual health care provider with primary practice located at 51 N 39Th St Medical Office Building, 1St Floor, Suite 120, Philadelphia PA 19104. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Surgical Critical Care, Allopathic & Osteopathic Physicians / Trauma Surgery. Allopathic & Osteopathic Physicians / Trauma Surgery is his primary health care specialty. Martin, Niels Douglas can be contacted via phone (215) 662-7320.Contact Information
Primary practice address
51 N 39Th St Medical Office Building, 1St Floor, Suite 120
Philadelphia PA 19104
Phone: (215) 662-7320
Fax: (215) 243-4605
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | MD420992 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Surgical Critical Care | 2086S0102X | MD420992 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Trauma Surgery | 2086S0127X | MD420992 | Pennsylvania |
Profile Details
| NPI number | 1013073477 |
|---|---|
| LBN Legal business name | Martin, Niels Douglas |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 29th, 2006 |
| Last updated | Nov 6th, 2019 - about 5 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 | 1013073477 | NPPES |
| New Jersey | MEDICAID | 0125024 | |
| New Jersey | MEDICAID | 1018343780005 |
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