Individual
RICHARD ELIOT MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-5030
(215) 707-3494
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-5030
(215) 707-3494
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD015576E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007346060001
—
PA
01
—
0061966000
INDEPENDENCE BC
PA
01
—
074823
HIGHMARK BS
PA
Enumeration date
03/30/2006
Last updated
03/21/2017
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