Individual
THOMAS DANIEL MARTIN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3000 SAINT MATTHEWS RD, ORANGEBURG, SC 29118-1442
(803) 747-9889
Mailing address
PO BOX 603484, CHARLOTTE, NC 28260-3484
(803) 765-1838
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
22520
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN2849
—
SC
Enumeration date
01/01/2019
Last updated
03/03/2025
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