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Individual

DR. JENNIFER P. MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
35 INTERNATIONAL DR, GREENVILLE, SC 29615-4816
(864) 234-7654
(864) 675-1657
Mailing address
35 INTERNATIONAL DR, GREENVILLE, SC 29615-4816
(864) 234-7654
(864) 675-1657

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
28804
SC
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
28804
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
288049
SC
01
8157
MEDICARE PTAN
SC
Enumeration date
06/29/2006
Last updated
10/11/2007
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