# DR. DAVID WENDELL MARTIN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1619195864
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 34359 | KY | Yes |

## Other

- **Enumeration date:** 04/23/2007
- **Last updated:** 07/15/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000042976 | BLUE CROSS BLUE SHIELD | KY |
| 01 | — | 000000523945 | ANTHEM | KY |
| 01 | — | 1529561 | UMWA | KY |
| 01 | — | 164138200 | FEDERAL BLACK LUNG | KY |
| 01 | — | 611330253 | COMMERCIAL INS | KY |
| 05 | — | 64343593 | — | KY |