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Dr. Nicholas Anthony Paul Martyak

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NPI Number Detailed Information

Provider Information:

Name: Dr. Nicholas Anthony Paul Martyak
Gender: M
Provider License Number If Given: 55268

NPI Information:

NPI: 1316946817
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 7/18/2005

Last Update Date: 8/20/2013

Provider Business Mailing Address:

Address: 396 LAKESHORE DR NE
Atlanta, GA 30307
Phone Number: 9122282439
Fax Number:

Provider Business Practice Location Address:

Address: 3651 WHEELER RD DEPARTMENT OF EMERGENCY MEDICINE
Augusta, GA 30909
Phone Number: 7066512369
Fax Number: 7066512364

Provider Taxonomy:

Primary: 207P00000X
Secondary (if any):
State: GA

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