Individual
DR. GREGORY BLAIN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
501 E HAMPDEN AVE, ENGLEWOOD, CO 80113-2702
(303) 761-9190
(720) 874-4462
Mailing address
10800 E GEDDES AVE STE 300, ENGLEWOOD, CO 80112-3895
(303) 761-9190
(720) 874-4462
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
04-38620
KS
2085R0202X
Diagnostic Radiology Physician
28911
NE
2085R0202X
Diagnostic Radiology Physician
56120
CO
2085R0202X
Diagnostic Radiology Physician
7465134-1205
UT
2085R0202X
Diagnostic Radiology Physician
MD18497
HI
2085R0204X
Vascular & Interventional Radiology Physician
7465134-1205
UT
2085R0204X
Vascular & Interventional Radiology Physician
Primary
DR.0056120
CO
390200000X
Student in an Organized Health Care Education/Training Program
73301
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
091605
—
AZ
01
—
10000009363001
BCBSU
UT
01
—
107120143101
SELECTHEALTH
UT
01
—
1137619
DMBA
UT
01
—
145450
PEHP
UT
01
—
1457529927
EMI HEALTH
UT
05
—
1457529927
—
IA
05
—
1457529927
—
MT
05
—
1457529927
—
UT
05
—
1457529927
—
WY
05
—
20062369A
—
OK
05
—
201127660A
—
KS
01
—
5033909
AETNA HEALTHCARE
UT
05
—
72231033
—
NM
05
—
81700059
—
CO
01
—
P01180703
RAILROAD MEDICARE
UT
Enumeration date
02/18/2008
Last updated
03/29/2024
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