Individual
DIANA JOYCE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
300 56TH ST SE, CHARLESTON, WV 25304-2308
(304) 926-1600
(304) 926-1649
Mailing address
300 56TH ST SE, CHARLESTON, WV 25304-2308
(304) 296-1600
(304) 926-1649
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
18268
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0080872000
—
WV
Enumeration date
07/13/2006
Last updated
12/22/2010
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