Individual
DR. HENRY MARTIN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3799 12TH STREET EXTENSION, STE 105, CAYCE, SC 29033
(803) 926-6820
Mailing address
PO BOX 896239, CHARLOTTE, NC 28289-6239
(803) 926-6820
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7360
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
073609
—
SC
Enumeration date
08/04/2006
Last updated
07/21/2022
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