Individual
JERRY MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1350 S KINGS DR, CHARLOTTE, NC 28207-2134
(704) 446-1242
Mailing address
1350 S KINGS DR, CHARLOTTE, NC 28207-2134
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
200400145
NC
Other
Enumeration date
07/28/2005
Last updated
04/15/2019
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