Individual
DR. MARTIE LEE PRICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
16817 MARVIN ROAD, CHARLOTTE, NC 28277
(704) 495-6036
Mailing address
5960 FAIRVIEW RD STE 500, CHARLOTTE, NC 28210-3113
(704) 495-6334
(704) 817-7219
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
200001172
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376561324
—
NC
01
—
137CA
BLUE CROSS BLUE SHIELD
NC
05
—
89137CA
—
NC
05
—
N0117A
—
SC
Enumeration date
07/18/2006
Last updated
06/05/2023
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