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Individual
KELIA B MARTIN
Active
Individual
KELIA B MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
010882
NY
363A00000X
Physician Assistant
Primary
PA10237
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
362061901
—
TX
Enumeration date
08/23/2006
Last updated
10/27/2016
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