Provider Demographics
NPI:1851121818
Name:MARTINEAU, CAROLINE (NP)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:MARTINEAU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2604 MONUMENT AVE APT C
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-2675
Mailing Address - Country:US
Mailing Address - Phone:336-314-5077
Mailing Address - Fax:
Practice Address - Street 1:9330 IRON BRIDGE RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-6700
Practice Address - Country:US
Practice Address - Phone:804-748-9090
Practice Address - Fax:804-751-4815
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024190869207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine