Individual
WALTER A. MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
251 E ANTIETAM ST, HAGERSTOWN, MD 21740-5724
(302) 709-4497
(302) 733-0854
Mailing address
251 E ANTIETAM ST, HAGERSTOWN, MD 21740-5724
(302) 709-4497
(302) 733-0854
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R148205
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R148205
LICENSE MARYLAND
MD
Enumeration date
01/19/2007
Last updated
10/09/2007
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