Individual
MELISSA KATHLEEN MARTIN
Active
Individual
MELISSA KATHLEEN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
058071
GA
208000000X
Pediatrics Physician
058071
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
747573398A
—
GA
05
—
747573398B
—
GA
Enumeration date
06/29/2006
Last updated
06/22/2010
Update your record
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