Individual
MR. CLYDE DONALD MARTIN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
87 MCGREGOR ST, STE. 1400, MANCHESTER, NH 03102-3765
(603) 647-9325
Mailing address
68 S SERVICE RD STE 350, MELVILLE, NY 11747-2358
(865) 342-8940
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
0024166498
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
4017
NC
Other
Enumeration date
01/19/2006
Last updated
06/04/2021
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