Individual
MARTIN TYLER DEAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
946 N MAIN ST, CHASE CITY, VA 23924-1139
(434) 372-5141
(434) 372-8910
Mailing address
946 N MAIN ST, CHASE CITY, VA 23924-1139
(434) 372-5141
(434) 372-8910
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101056743
VA
207R00000X
Internal Medicine Physician
9701734
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104W
BCBS INDIVIDUAL NUMBER
NC
05
—
891104W
—
NC
Enumeration date
08/30/2005
Last updated
01/07/2022
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