Individual
BETSY ANNE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
873 ROBERTSON BLVD, WALTERBORO, SC 29488-3082
(843) 542-9535
(843) 542-9675
Mailing address
873 ROBERTSON BLVD, WALTERBORO, SC 29488-3082
(843) 542-9535
(843) 542-9675
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
TL2583
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TL2583
STATE LICENSE
SC
Enumeration date
07/05/2016
Last updated
07/05/2016
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