| NPI | 1669970067 |
|---|---|
| Former Legal Business Name | CHRISTA L MARTIN DBA SOUTH SIDE PEDIATRICS |
| Entity Type | Organization |
| Authorized Contact | CHRISTA MARTIN Owner 240-513-6300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MD 193525) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2018-01-31 |
| Last Update Date | 2022-06-09 |