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Individual

MR. CALEB DAVID MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
327 MEDICAL PARK DR, BRIDGEPORT, WV 26330-9006
(681) 342-1000
Mailing address
2673 DAVISSON RUN RD STE 303, CLARKSBURG, WV 26301-6838
(800) 541-4009

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
103459
WV
367500000X
Certified Registered Nurse Anesthetist
Primary
86131
WV

Other

Enumeration date
04/25/2019
Last updated
08/04/2023
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