Individual
LARRY MARTIN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
2000 WELLNESS BLVD STE 140, MONROE, NC 28110-3354
(704) 316-2338
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-7834
(704) 316-7110
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
11012750A
IN
207X00000X
Orthopaedic Surgery Physician
Primary
2011-01084
NC
207X00000X
Orthopaedic Surgery Physician
35.095415
OH
207X00000X
Orthopaedic Surgery Physician
43478
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558529438
—
NC
05
—
NC1461
—
SC
Enumeration date
05/28/2008
Last updated
10/25/2020
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