Individual
DR. JERMELIAH MONIQUE TODD MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 HAWTHORNE LN, CHARLOTTE, NC 28204-2515
(704) 384-4021
(704) 384-5601
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-4021
(704) 384-5601
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
01068449A
IN
208000000X
Pediatrics Physician
2011-00863
NC
208M00000X
Hospitalist Physician
Primary
2011-00863
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356517692
—
NC
05
—
200990620
—
IN
05
—
5919171
—
NC
Enumeration date
05/06/2008
Last updated
02/01/2022
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