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Individual

CHARLES JAY MARTI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
600 N PICKAWAY ST, CIRCLEVILLE, OH 43113-2409
(740) 474-2126
(740) 477-1022
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
(937) 619-4231

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35053086
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000317196
BCBS CIRCLEVILLE
01
000000326800
BCBS
05
0615383
OH
01
P00111888
RAILROAD MEDICARE
Enumeration date
05/10/2006
Last updated
06/11/2008
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