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Individual
ALAN P MARTIN
Active
Individual
ALAN P MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003258
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3671874
—
TN
01
—
4068157
BCBS OF TENNESSEE
TN
05
—
95006177
—
KY
Enumeration date
07/05/2006
Last updated
11/15/2007
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