Individual
CHARLES K MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
225000 HUMMINGBIRD RD STE 100, WAUSAU, WI 54401-2950
(715) 359-6442
Mailing address
225000 HUMMINGBIRD RD STE 100, WAUSAU, WI 54401-2950
(715) 359-6442
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10000978A
IN
363A00000X
Physician Assistant
Primary
3241-23
WI
Other
Enumeration date
12/18/2007
Last updated
06/17/2021
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