Provider Demographics
NPI:1942000609
Name:MARTIN, NATHAN THOMAS (NRP)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:THOMAS
Last Name:MARTIN
Suffix:
Gender:M
Credentials:NRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 CONESTOGA CT
Mailing Address - Street 2:
Mailing Address - City:BOONSBORO
Mailing Address - State:MD
Mailing Address - Zip Code:21713-1411
Mailing Address - Country:US
Mailing Address - Phone:509-303-8215
Mailing Address - Fax:
Practice Address - Street 1:105 CONESTOGA CT
Practice Address - Street 2:
Practice Address - City:BOONSBORO
Practice Address - State:MD
Practice Address - Zip Code:21713-1411
Practice Address - Country:US
Practice Address - Phone:509-303-8215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
M5073861146L00000X
MD0022704146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic