Individual
ALVIN W. MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2307 GREENE WAY, LOUISVILLE, KY 40220-4009
(502) 897-9594
(502) 736-4456
Mailing address
PO BOX 950251, LOUISVILLE, KY 40295-0251
(502) 897-9594
(502) 736-4456
Taxonomy
Speciality
Code
Description
License number
State
207ZH0000X
Hematology (Pathology) Physician
22866
KY
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
22866
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000596219
ANTHEM-BLUE CROSS-BLUE SHIELD
KY
05
—
200071070
—
IN
01
—
3691838000
PASSPORT ADVANTAGE
KY
01
—
50021837
PASSPORT HEALTH PLAN
KY
05
—
64228661
—
KY
Enumeration date
12/23/2005
Last updated
07/06/2010
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