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Individual

EDMUND F MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
333 COTTMAN AVE, PHILADELPHIA, PA 19111-2434
(215) 728-2844
(215) 214-1425
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 728-2844
(215) 214-1425

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD425709
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100727800
MEDICAID GROUP TPI
PA
01
597586
MEDICARE GROUP TPI
PA
01
CD4829
RAIL ROAD MEDICARE TPI
PA
Enumeration date
07/04/2006
Last updated
04/06/2018
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