Individual
JEFFREY M. MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
46440 BENEDICT DR, SUITE 107, STERLING, VA 20164-6602
(703) 450-1125
(703) 450-1145
Mailing address
PO BOX 17334, BALTIMORE, MD 21297-1334
(703) 443-6717
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101222441
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942379573
—
VA
Enumeration date
11/07/2006
Last updated
04/27/2011
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