Provider Demographics
NPI:1447378963
Name:MARTIN, PATRICK E (PA)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:E
Last Name:MARTIN
Suffix:
Gender:M
Credentials:PA
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Other - Last Name:
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Mailing Address - Street 1:3990 E US HIGHWAY 64 ALT
Mailing Address - Street 2:MURPHY MEDICAL CENTER
Mailing Address - City:MURPHY
Mailing Address - State:NC
Mailing Address - Zip Code:28906-6843
Mailing Address - Country:US
Mailing Address - Phone:828-837-8161
Mailing Address - Fax:828-835-7723
Practice Address - Street 1:3990 E US HIGHWAY 64 ALT
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906-6843
Practice Address - Country:US
Practice Address - Phone:828-837-8161
Practice Address - Fax:828-835-7723
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC100951363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCR39723Medicare UPIN
NC2766207Medicare ID - Type Unspecified