Individual
MARTA T SPAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1701 CURTIS RD, CHAMPAIGN, IL 61822-9678
(217) 326-1477
(217) 326-1110
Mailing address
611 W. PARK ST., BWPC, URBANA, IL 61801-2500
(217) 383-6792
(217) 383-4752
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
45526
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018601
KAISER COMMERCIAL NUMBER
CO
05
—
15273865
—
CO
Enumeration date
03/28/2006
Last updated
05/13/2014
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