Individual
FREDERICK CARL MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2900 1ST AVE, OPC SUITE 230, HUNTINGTON, WV 25702
(304) 525-3711
(304) 525-2748
Mailing address
PO BOX 4190, BARBOURSVILLE, WV 25504-4190
(304) 399-4405
(304) 399-2526
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
19638
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0130543001
—
WV
01
—
51D2006880
CLIA NUMBER
WV
Enumeration date
10/03/2006
Last updated
05/19/2022
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