Individual
DR. MARTIN JOHN SPALDING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D,
Contact information
Practice address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169-4810
(803) 936-8146
(803) 936-8916
Mailing address
PO BOX 2375, WEST COLUMBIA, SC 29171-2375
(803) 936-8146
(803) 936-8916
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
111687
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100428960A
—
KS
05
—
100428960B
—
KS
05
—
204837819
—
MO
01
—
30544018
KANSAS CITY BCBS
MO
05
—
314252
—
SC
01
—
442180
BCBS
KS
Enumeration date
04/13/2006
Last updated
03/03/2016
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