Individual
DR. JAMES WALLACE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1425 PORTER ST, USAMRIID, MED DIV, FORT DETRICK, MD 21702-9211
(301) 619-4884
(301) 619-2196
Mailing address
9010 CHARLES AUGUSTINE DR, ALEXANDRIA, VA 22308-2822
(301) 619-4884
(301) 619-2196
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
08021
MS
Other
Enumeration date
12/13/2006
Last updated
07/08/2007
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