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Individual
MR. KEVIN LEE MARTIN
Active
Individual
MR. KEVIN LEE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01611
SC
207Q00000X
Family Medicine Physician
Primary
2019-01716
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2019-01716
NCMB
NC
Enumeration date
04/09/2009
Last updated
09/04/2019
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