Individual
CANDICE IMAN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
7853 PACER DR STE 3A, DELAWARE, OH 43015-7571
(614) 788-9030
Mailing address
PO BOX 7527, DUBLIN, OH 43017-0727
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34010862
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0085270
—
OH
Enumeration date
06/14/2010
Last updated
01/25/2022
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