Individual
MR. CARLOS IVAN MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1035 ALTO ST, SANTA FE, NM 87501-2406
(505) 982-4425
Mailing address
1035 ALTO ST, SANTA FE, NM 87501-2406
(505) 982-4425
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD2024-0621
NM
Other
Enumeration date
04/02/2021
Last updated
08/29/2024
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