Provider Demographics
NPI:1659959526
Name:MARTEN, ABEL
Entity type:Individual
Prefix:
First Name:ABEL
Middle Name:
Last Name:MARTEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USNH/USNMRTC GUANTANAMO BAY
Mailing Address - Street 2:PSC 1005 BOX 11185
Mailing Address - City:GUANTANAMO BAY
Mailing Address - State:GUANTANAMO BAY
Mailing Address - Zip Code:FPO AA 34009
Mailing Address - Country:CU
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:USNH/USNMRTC GUANTANAMO BAY
Practice Address - Street 2:PSC 1005 BOX 11185
Practice Address - City:GUANTANAMO BAY
Practice Address - State:GUANTANAMO BAY
Practice Address - Zip Code:FPO AA 34009
Practice Address - Country:CU
Practice Address - Phone:760-725-1288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE34873207Q00000X
171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No171000000XOther Service ProvidersMilitary Health Care Provider