Individual
TIMOTHY JOHN MARTIN
Active
Individual
TIMOTHY JOHN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
34084
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3500
PARTNERS
NC
01
—
45602
MEDCOST
NC
01
—
54429
BCBS
NC
01
—
5735102
AETNA
—
05
—
6324207
—
VA
05
—
8954429
—
NC
05
—
9840171000
—
WV
05
—
Q34084
—
SC
Enumeration date
11/28/2005
Last updated
08/20/2010
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