Individual
MARTINA A GREEN-MCGOWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
236 SIMPSON AVE, ELKHART, IN 46516
(574) 293-0052
(574) 293-3744
Mailing address
236 SIMPSON AVE, ELKHART, IN 46516-4666
(574) 293-0052
(574) 293-3744
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01041734
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100357660
—
IN
Enumeration date
06/13/2005
Last updated
04/18/2019
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