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Individual

DR. DAN C MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1008 DRUID PARK AVE STE 101, AUGUSTA, GA 30904-5848
(770) 962-3642
(770) 962-3643
Mailing address
455 PHILIP BLVD STE 140, LAWRENCEVILLE, GA 30046-8768
(770) 962-3642
(770) 962-3643

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
024031
GA
207LP2900X
Pain Medicine (Anesthesiology) Physician
024031
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000288626E
GA
05
000288626F
GA
01
048398
BCBS
GA
01
050090631
RRMEDICARE
GA
01
339275
WELLCARE CMO
GA
01
550789920
TRICARE
GA
05
G24031
SC
Enumeration date
07/07/2006
Last updated
04/01/2026
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