Organization
NORTHEASTERN DERMATOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIS E MARTIN MD (OWNER/PHYSICIAN)
(252) 903-1372
Entity
Organization
Contact information
Practice address
135 WOODRIDGE CT, ROCKY MOUNT, NC 27804-2294
(252) 903-1372
Mailing address
135 WOODRIDGE CT, ROCKY MOUNT, NC 27804-2294
(252) 903-1372
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
09/03/2020
Last updated
09/03/2020
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