Provider Demographics
NPI:1871525857
Name:MARTIN MEDICAL ASSOCIATE
Entity type:Organization
Organization Name:MARTIN MEDICAL ASSOCIATE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-621-3661
Mailing Address - Street 1:4815 LIBERTY AVE
Mailing Address - Street 2:SUITE 331
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-2156
Mailing Address - Country:US
Mailing Address - Phone:412-621-3661
Mailing Address - Fax:412-621-3676
Practice Address - Street 1:4815 LIBERTY AVE
Practice Address - Street 2:SUITE 331
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-2156
Practice Address - Country:US
Practice Address - Phone:412-621-3661
Practice Address - Fax:412-621-3676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA061557Medicare ID - Type Unspecified