Provider Demographics
NPI:1497546592
Name:MARTIN, SAVANNA MAYE
Entity type:Individual
Prefix:
First Name:SAVANNA
Middle Name:MAYE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7105 BRANDY RUN DR APT 209
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-3710
Mailing Address - Country:US
Mailing Address - Phone:804-298-4722
Mailing Address - Fax:
Practice Address - Street 1:7105 BRANDY RUN DR APT 209
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-3710
Practice Address - Country:US
Practice Address - Phone:804-298-4722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program