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Individual
DR. KENNETH J MARTIN
Active
Individual
DR. KENNETH J MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC002881L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010465050004
—
PA
01
—
0060738000
IBC
PA
01
—
0104650501
AMERICHOICE OF PA
PA
01
—
11940
HEALTH PARTNERS PA
PA
01
—
1480
BRAVO ELDERHEALTH
PA
01
—
175404
BC BS OF PA
PA
01
—
31875
KEYSTONE MERCY HEALTH PLA
PA
Enumeration date
08/19/2005
Last updated
01/26/2015
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