Organization
LYNORE M MARTINEZ MD PROFESSIONAL ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LYNORE M MARTINEZ MD (OWNER)
(505) 988-4922
Entity
Organization
Contact information
Practice address
405 KIVA CT, SANTA FE, NM 87505
(505) 988-4922
(505) 988-4924
Mailing address
405 KIVA CT, SANTA FE, NM 87505
(505) 988-4922
(505) 988-4924
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
95294
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00068674
—
NM
01
—
NM009T01
BLUE CROSS
NM
Enumeration date
10/22/2007
Last updated
12/21/2007
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