Organization
GREAT COVE INTEGRATIVE MEDICINE LLC
Active
Organization
GREAT COVE INTEGRATIVE MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHARON EUNICE MARTIN MD PHD (OWNER)
(717) 485-4131
Entity
Organization
Contact information
Practice address
124 S 2ND ST, MC CONNELLSBURG, PA 17233-1446
(717) 485-4131
(717) 485-3394
Mailing address
124 S 2ND ST, MC CONNELLSBURG, PA 17233-1446
(717) 485-4131
(717) 485-3394
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD067389L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017504800005
—
PA
01
—
133213
HIGHMARK BLUE SHIELD
PA
01
—
5008657
CAPITAL BLUE CROSS
PA
Enumeration date
02/28/2007
Last updated
04/20/2012
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