Provider Demographics
NPI:1154380350
Name:TAORMINA, MARTIN VINCENT (MD)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:VINCENT
Last Name:TAORMINA
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 1:1721 EBENEZER RD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-4103
Mailing Address - Country:US
Mailing Address - Phone:803-985-4000
Mailing Address - Fax:803-985-4006
Practice Address - Street 1:986 WELLNESS WAY STE 330
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29715-7353
Practice Address - Country:US
Practice Address - Phone:803-265-3986
Practice Address - Fax:803-752-0101
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9601496208600000X, 2086S0129X
SC238652086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP3758Medicaid
SCGP3758Medicaid
SC7710Medicare ID - Type Unspecified