Provider Demographics
NPI:1104890284
Name:ARTMAN, MARTIN R (MD)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:R
Last Name:ARTMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2916 GLYNN AVE
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-4844
Mailing Address - Country:US
Mailing Address - Phone:912-466-5850
Mailing Address - Fax:912-267-7139
Practice Address - Street 1:3222 SHRINE RD STE A
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-4357
Practice Address - Country:US
Practice Address - Phone:912-264-6303
Practice Address - Fax:912-264-6323
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-15
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA030945207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000373898UMedicaid
GA000373898SMedicaid
GA01158097OtherAMERIGROUP
GA01158097OtherAMERIGROUP
SC511I930149Medicare PIN
GAD28819Medicare UPIN