Individual
AMY C. MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110001363
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0110001363
STATE LICENSE
VA
Enumeration date
02/08/2007
Last updated
03/07/2023
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