Individual
JACK L MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
415 WYNTRE LEA DR, BRYN MAWR, PA 19010-2038
(610) 331-5849
Mailing address
415 WYNTRE LEA DR, BRYN MAWR, PA 19010-2038
(610) 331-5849
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
M9484
TX
207RC0000X
Cardiovascular Disease Physician
MD022890E
PA
207RI0011X
Interventional Cardiology Physician
Primary
129873-01
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8F8997
MEDICARE INDIVIDUAL PTAN
TX
Enumeration date
06/22/2005
Last updated
06/29/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us