Dr Dan C Martin, MD | |
1008 Druid Park Ave Ste 101, Augusta, GA 30904-5848 | |
(770) 962-3642 | |
(770) 962-3643 |
Full Name | Dr Dan C Martin |
---|---|
Gender | Male |
Speciality | Anesthesiology - Pain Medicine |
Location | 1008 Druid Park Ave Ste 101, Augusta, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1578595831 | NPI | - | NPPES |
G24031 | Medicaid | SC | |
550789920 | Other | GA | TRICARE |
000288626E | Medicaid | GA | |
050090631 | Other | GA | RRMEDICARE |
000288626F | Medicaid | GA | |
339275 | Other | GA | WELLCARE CMO |
048398 | Other | GA | BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207L00000X | Anesthesiology | 024031 (Georgia) | Secondary |
207LP2900X | Anesthesiology - Pain Medicine | 024031 (Georgia) | Primary |
Entity Name | Au Medical Associates Anesthesia Billing Services, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1801843933 PECOS PAC ID: 1557256393 Enrollment ID: O20040219000488 |
Mailing Address | Practice Location Address |
---|---|
Dr Dan C Martin, MD 455 Philip Blvd Ste 140, Lawrenceville, GA 30046-8768 Ph: (770) 962-3642 | Dr Dan C Martin, MD 1008 Druid Park Ave Ste 101, Augusta, GA 30904-5848 Ph: (770) 962-3642 |
Rosa Maria Lopez Rincon, Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1120 15th St, Augusta, GA 30912 Phone: 706-446-5836 | |
Yulia Kungurova, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 1120 15th St # Bi-2183, Augusta, GA 30912 Phone: 706-721-0180 | |
Richard E. Lynch, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 804 Scott Nixon Memorial Dr, Attn: Provider Enrollment, Augusta, GA 30907 Phone: 800-394-4445 Fax: 706-955-0735 | |
Dr. Edward Kurt Leahy, Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1 Freedom Way, Augusta, GA 30904 Phone: 706-733-0188 | |
Dr. Marshall D. Bedder, M.D. Anesthesiology Medicare: Medicare Enrolled Practice Location: 1120 15th St, Augusta, GA 30912 Phone: 706-721-3813 | |
Dr. John William Whiteley, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 1120 15th St, Augusta, GA 30912 Phone: 706-721-3873 Fax: 706-721-7763 | |
Sami Mohammad Hafsa, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1120 15th St, Augusta, GA 30912 Phone: 706-721-3871 |