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Organization
INDIANA ENDOVASCULAR SPECIALISTS LLC
Active
Organization
INDIANA ENDOVASCULAR SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRANDON K MARTINEZ MD (OWNER AND MEDICAL DIRECTOR)
(317) 656-9089
Entity
Organization
Contact information
Practice address
3743 LANDMARK DR STE 300, LAFAYETTE, IN 47905-6656
(317) 656-9089
Mailing address
11502 SEAFAN CT, INDIANAPOLIS, IN 46236-8913
(317) 656-9089
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
2086S0129X
Vascular Surgery Physician
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201022130
—
IN
Enumeration date
12/16/2021
Last updated
02/22/2022
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