Individual
KELLY MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
34TH STREET AND CIVIC CENTER BOULEVARD, SUITE 7C26, PHILADELPHIA, PA 19104
(215) 590-7430
Mailing address
34TH STREET AND CIVIC CENTER BOULEVARD, SUITE 7C26, PHILADELPHIA, PA 19104
(215) 590-7430
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
MT201919
PA
Other
Enumeration date
04/23/2009
Last updated
07/10/2012
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