Provider Demographics
NPI:1962590208
Name:PRITZKER, MARTIN S (MD)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:S
Last Name:PRITZKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4 SHADY OAK LN
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31411-2124
Mailing Address - Country:US
Mailing Address - Phone:912-598-1064
Mailing Address - Fax:912-355-8329
Practice Address - Street 1:712 E 70TH ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4811
Practice Address - Country:US
Practice Address - Phone:912-352-8974
Practice Address - Fax:912-355-8329
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA13676207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD38518Medicare UPIN
GA08BBVVKMedicare ID - Type Unspecified