Individual
EDWARD GEORGE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
29 MAPLE ST, LITTLETON, NH 03561-4729
(603) 444-5358
Mailing address
87 WASHINGTON ST, CONWAY, NH 03818-6044
(603) 447-3347
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
301
NH
103TC0700X
Clinical Psychologist
Primary
301
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0602266Y0NH01
ANTHEM
NH
Enumeration date
03/09/2007
Last updated
05/18/2012
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