Individual
DR. MARK L MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8 TH AVENUE AND C ST, SALT LAKE CITY, UT 84143-0001
(801) 408-7100
(801) 296-1715
Mailing address
PO BOX 1249, BOUNTIFUL, UT 84011-1249
(801) 296-2113
(801) 296-1715
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
4975474-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508861964
—
UT
Enumeration date
06/14/2005
Last updated
06/01/2015
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