Samuel Travis Martin
Nurse Anesthetist, Certified Registered in Raleigh, NC. Individual provider (NPI-1).
NPI number1831789544
StatusActive
Last updated in NPPESJan 26, 2021
Details
- NPI
- 1831789544
- Entity type
- Individual (NPI-1)
- Name
- Mr. Samuel Travis Martin
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jan 26, 2021
- Certification date
- Jan 26, 2021
- Last updated
- Jan 26, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 6565 | NC | Yes |
Practice location
3400 Wake Forest RdRaleigh, NC 27609-7317
Phone 919-954-3000
Mailing address
520 Stoney Creek AveBaton Rouge, LA 70808-8186
Phone 907-350-4439
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