Organization
WALLACE F. MARTIN, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WALLACE FORD MARTIN M.D. (OWNER)
(770) 962-9977
Entity
Organization
Contact information
Practice address
631 PROFESSIONAL DR, SUITE 300, LAWRENCEVILLE, GA 30046-3371
(770) 962-9977
(770) 339-9804
Mailing address
631 PROFESSIONAL DRIVE, SUITE 300, LAWRENCEVILLE, GA 30046-3371
(770) 962-9977
(770) 339-9804
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
026153
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00301914A
—
GA
01
—
GRP1797
MEDICARE GROUP#
GA
Enumeration date
07/02/2007
Last updated
09/01/2010
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us