Individual
DR. DERRICK A MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
18131
MD
225100000X
Physical Therapist
2656
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001
CAREFIRST BCBS
DC
01
—
01302934
AMERIGROUP
MD
01
—
545048096
CAREFIRST BCBS
MD
05
—
961002200
—
MD
Enumeration date
03/22/2007
Last updated
11/27/2009
Update your record
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