Individual
MR. MARTIN LAMAR GUNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
605 N FRASER ST, GEORGETOWN, SC 29440-3265
(843) 545-9999
(843) 545-1099
Mailing address
605 N FRASER ST, GEORGETOWN, SC 29440-3265
(843) 545-9999
(843) 545-1099
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
C15792
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DE1513
—
SC
Enumeration date
05/23/2007
Last updated
03/18/2008
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