Individual
JULIE MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1414 LUISA ST, SANTA FE, NM 87505-4347
(505) 930-5040
Mailing address
1414 LUISA ST, SANTA FE, NM 87505-4347
(505) 930-5040
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
41258
CO
207Q00000X
Family Medicine Physician
Primary
MD2007-0780
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30928818
—
CO
01
—
70156034
NEW MEXICO MEDICAID
—
01
—
840706945158
ROCKY MOUNTAIN HEALH PLAN
CO
01
—
MA666493
ANTHEM BCBS
CO
01
—
P00120116
TRAVELERS MEDICARE
—
Enumeration date
10/11/2005
Last updated
03/28/2015
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