Individual
DR. WILMONT GREGORY MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1818 REMOUNT RD, CHARLESTON, SC 29406-3239
(843) 766-6308
(866) 533-4473
Mailing address
1871 SAVAGE RD, CHARLESTON, SC 29407-4726
(843) 766-6308
(843) 804-9883
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
57-011973
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
352843
—
SC
01
—
57-011973
TRAINING CERTIFICATE
OH
Enumeration date
01/08/2007
Last updated
02/19/2020
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