Charles K Martin, PA
Physician Assistant in Wausau, WI. Individual provider (NPI-1).
NPI number1114101813
StatusActive
Last updated in NPPESJun 17, 2021
Details
- NPI
- 1114101813
- Entity type
- Individual (NPI-1)
- Name
- Charles K Martin
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 18, 2007
- Certification date
- Jun 17, 2021
- Last updated
- Jun 17, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 3241-23 | WI | Yes |
| 363A00000X | Physician Assistant | 10000978A | IN |
Practice location
225000 Hummingbird Rd Ste 100Wausau, WI 54401-2950
Phone 715-359-6442
Mailing address
225000 Hummingbird Rd Ste 100Wausau, WI 54401-2950
Phone 715-359-6442
Other practice locations
5050 N Clinton St
Fort Wayne, IN 46825-5822
Fort Wayne, IN 46825-5822
Phone 260-484-8551 · Fax 260-484-9603
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All 76 Physician Assistant providers in Wausau · All 2,366 providers in Wausau
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