Individual
CARLOS O MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
165 EMERY HWY, STE 100, MACON, GA 31217-3666
(478) 741-2150
(478) 741-2208
Mailing address
165 EMERY HWY, STE 100, MACON, GA 31217-3666
(478) 741-2150
(478) 741-2208
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
031793
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00459841M
—
GA
05
—
00459841N
—
GA
05
—
00459841U
—
GA
01
—
390007351
RAILROAD MEDICARE
GA
01
—
CJ4042
RAILROAD MEDICARE GROUP
GA
Enumeration date
11/30/2006
Last updated
05/02/2024
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