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Individual
MR. BRIAN T. MARTIN
Active
Individual
MR. BRIAN T. MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1767
ID
363A00000X
Physician Assistant
PA21543
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0969PA
—
SC
01
—
P00886826
RAILROAD MC ID-RSFPN
SC
05
—
PA-1767
—
ID
Enumeration date
02/28/2010
Last updated
02/20/2024
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