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Individual

MICHAEL PAUL MARTINELLI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A-C

Contact information

Practice address
2701 NORTH DECATUR ROAD, DECATUR, GA 30033
(404) 501-1849
Mailing address
2100 POWELL STREET, STE 920, EMERYVILLE, CA 94608-1803
(510) 350-2600
(510) 879-9100

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
004436
GA
363A00000X
Physician Assistant
Primary
2024032326
MO
363A00000X
Physician Assistant
4436
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
911331220A
GA
05
911331220B
GA
Enumeration date
06/21/2006
Last updated
10/25/2024
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