Individual
RICHARD A MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
160 NEWTOWN RD STE 102, VIRGINIA BEACH, VA 23462-2403
(757) 461-3101
Mailing address
PO BOX 45923, BALTIMORE, MD 21297-5923
(877) 969-0392
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000403
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009236457
—
VA
01
—
4323400003
MEDICARE DME
—
01
—
453837
BCBS
VA
Enumeration date
06/30/2006
Last updated
07/26/2024
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