Organization Active NPI

George L Martin MD PC

  • Allergy & Immunology (Internal Medicine) Physician
  • Wynnewood, PA
National Provider Identifier
1750300778
Registry record updated Sep 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology (Internal Medicine) PhysicianTaxonomy code 207RA0201X
Legal business name
GEORGE L MARTIN MD PC
Practice address
100 E Lancaster Ave
Suite 237 West Lankenau Medical Building
Wynnewood, PA 19096-3450
Phone
(610) 649-9300
Fax
(610) 896-4617
NPI assigned
Jul 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
George L Martin, MDNPI 1225051337
Title
Physician
Phone
(610) 649-9300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RA0201X Primary

Addresses

Primary practice location

100 E Lancaster Ave
Suite 237 West Lankenau Medical Building
Wynnewood, PA 19096-3450

Mailing address

100 E Lancaster Ave
Suite 237 West Lankenau Medical Building
Wynnewood, PA 19096-3450
Phone (610) 649-9300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040621001652 PA Part B Supplier - Clinic/Group Practice 0345225629 Receives reassigned benefits from 2 practitioners
Practice locations: Upper Darby, PA; Wynnewood, PA

National Provider Directory

National Provider Directory

Locations

841 Garrett Rd
Upper Darby, PA 19082
Phone (610) 652-3323

100 E Lancaster Ave
Ste 237W
Wynnewood, PA 19096
Phone (610) 649-9300

100 E Lancaster Ave
Ste 237
Wynnewood, PA 19096

100 E Lancaster Ave
Ste W237
Wynnewood, PA 19096
Phone (610) 649-9300

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379635200000",
    "number": "1750300778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "address_2": "SUITE 237 WEST LANKENAU MEDICAL BUILDING",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "610-649-9300",
            "fax_number": "610-896-4617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "address_2": "SUITE 237 WEST LANKENAU MEDICAL BUILDING",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "610-649-9300",
            "fax_number": "610-896-4617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE L MARTIN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2013-09-20",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "610-649-9300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RA0201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.