Martinez, Mark
Martinez, Mark is an individual health care provider with primary practice located at 101 'D' Avenue Black Rock, Zuni NM 87327-0101. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Martinez, Mark can be contacted via phone (505) 782-4710.Contact Information
Primary practice address
101 'D' Avenue Black Rock
Zuni NM 87327-0101
Phone: (505) 782-4710
Fax: (505) 782-5880
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 006263 | New Mexico |
Profile Details
| NPI number | 1518291558 |
|---|---|
| LBN Legal business name | Martinez, Mark |
| Credentials | LADAC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 23rd, 2009 |
| Last updated | Sep 23rd, 2009 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1518291558 | NPPES |
| New Mexico | MEDICAID | 70702713 |
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