Individual
KEVIN SAMUEL MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1310 SOUTHERN AVE SE, WASHINGTON, DC 20032-4623
(252) 933-0005
Mailing address
3710 UNIVERSITY DR STE 330, DURHAM, NC 27707-6204
(252) 933-0005
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
092767-23
NH
363LF0000X
Family Nurse Practitioner
Primary
5005307
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
168G5
BCBS
—
05
—
7005432
—
NC
Enumeration date
10/04/2011
Last updated
12/08/2023
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