Individual
LEONA MARIE MARTIN
Active
Individual
LEONA MARIE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
21951
AZ
207R00000X
Internal Medicine Physician
Primary
21951
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154500002
—
AZ
01
—
AZ0158190
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
05/04/2006
Last updated
11/17/2015
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