Individual
FREDERICK MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 MEADOWS PKWY, VIDALIA, GA 30474-8759
(912) 535-5555
(912) 537-0865
Mailing address
PO BOX 663, VIDALIA, GA 30475-0663
(912) 535-5555
(912) 537-0865
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
060185
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
755529465A
—
GA
Enumeration date
01/22/2007
Last updated
10/17/2019
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