Individual
MR. JEFFREY BRIAN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
145 KIMEL PARK DR, SUITE 220, WINSTON SALEM, NC 27103-6984
(336) 794-0057
(336) 794-0501
Mailing address
8330 LISMORE ST, CLEMMONS, NC 27012-8854
(336) 794-0501
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
102867
NC
Other
Enumeration date
05/12/2006
Last updated
02/01/2024
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