Individual
KARA DAWN MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8312 KASEMAN CT NE, ALBUQUERQUE, NM 87110-7639
(505) 291-5300
(505) 291-5301
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
MD2012-0137
NM
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
MD2012-0137
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
84434252
—
NM
Enumeration date
04/06/2009
Last updated
03/31/2016
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