| Mary A Martin Np Bc | |
|
10430 Haddington Dr Nw Charlotte NC 28269-6955 | |
| (704) 200-1122 | |
| (704) 464-1781 |
| Full Name | Mary A Martin Np Bc |
|---|---|
| Speciality | Clinic/Center |
| Location | 10430 Haddington Dr Nw, Charlotte, North Carolina |
| Authorized Official Name and Position | Mary Ann Martin (PSYCHIATRIC NURSE PRACTITIONER OWNE) |
| Authorized Official Contact | 7042001122 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary A Martin Np Bc 6809 Fairview Rd Charlotte NC 28210-4195 Ph: (704) 200-1122 | Mary A Martin Np Bc 10430 Haddington Dr Nw Charlotte NC 28269-6955 Ph: (704) 200-1122 |
| NPI Number | 1609313311 |
|---|---|
| Provider Enumeration Date | 01/20/2017 |
| Last Update Date | 01/20/2017 |
| Medicare PECOS PAC ID | 8022393321 |
|---|---|
| Medicare Enrollment ID | O20170329001658 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609313311 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 5002313 (North Carolina) | Primary |
| Provider Name | Mary A Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598821191 PECOS PAC ID: 6800968660 Enrollment ID: I20080710000609 |
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