Individual
DR. KENNETH J MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
7331 BRENTWOOD RD, PHILADELPHIA, PA 19151
(215) 877-2555
(215) 877-0240
Mailing address
408 HELEN CIR, PENN VALLEY, PA 19072-1222
(215) 877-2555
(215) 877-0240
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC002881L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010465050004
—
PA
01
—
0060738000
IBC
PA
01
—
0104650501
AMERICHOICE OF PA
PA
01
—
11940
HEALTH PARTNERS PA
PA
01
—
1480
BRAVO ELDERHEALTH
PA
01
—
175404
BC BS OF PA
PA
01
—
31875
KEYSTONE MERCY HEALTH PLA
PA
Enumeration date
08/19/2005
Last updated
01/26/2015
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