Individual
ELISE DANIELLE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2383 PATE ST N, SNELLVILLE, GA 30078-3250
(770) 972-4845
Mailing address
701 GROVE RD, GREENVILLE, SC 29605-4210
(864) 455-7882
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
95840
GA
207R00000X
Internal Medicine Physician
LL52479
SC
Other
Enumeration date
06/12/2018
Last updated
11/09/2023
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