Individual
DR. NICHOLAS ANTHONY PAUL MARTYAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3651 WHEELER RD, DEPARTMENT OF EMERGENCY MEDICINE, AUGUSTA, GA 30909-6521
(706) 651-2369
(706) 651-2364
Mailing address
396 LAKESHORE DR NE, ATLANTA, GA 30307-1746
(912) 228-2439
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
055268
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
057308333A
—
GA
01
—
10062858
AMERIGROUP
—
01
—
1447352778
NPI - CSRA EMERGENCY PHYS
—
01
—
345608
WELLCARE OF GA
—
Enumeration date
07/18/2005
Last updated
08/20/2013
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