Carolyn Goodrich Martin, M.D.
Individual provider Active NPI Legal Medicine · Kalkaska, MI
NPI 1205013307 · NPPES record last updated Jan 31, 2008
Key facts
- NPI
- 1205013307
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Legal Medicine 173000000X
- License
- 4301049495 (MI)
- Practice address
- 713 4TH St
Kalkaska, MI 49646-9506 - Phone
- (231) 258-9586
- NPI assigned
- Jan 31, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301049495 | MI | MD | Legal Medicine |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kalkaska Memorial Health Center | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Legal Medicine | 173000000X | 4301049495 | MI | Yes |
Addresses
Primary practice location
713 4TH St
Kalkaska, MI 49646-9506
Mailing address
713 4TH St
Kalkaska, MI 49646-9506
Phone (231) 258-9586
Other providers in Kalkaska, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.