Individual
DR. MARTIN WALLACE CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
35422
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13725
BC PROVIDER NUMBER
IA
05
—
36682
—
IA
Enumeration date
10/07/2005
Last updated
08/20/2021
Update your record
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