Individual
DR. DIANNE MARTIN
Active
Individual
DR. DIANNE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
01029502
IN
2084P0800X
Psychiatry Physician
Primary
01029502A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000079659
BCBS
—
05
—
100235680
—
IN
05
—
10023568019
—
IN
01
—
I010268
TRICARE
—
Enumeration date
09/06/2006
Last updated
02/06/2024
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