Individual
DR. ENRIQUE STANLEY MARTINEZ ONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13991 W GRAND AVE STE 105, SURPRISE, AZ 85374-3065
(623) 455-7800
(234) 557-8306
Mailing address
PO BOX 10880, PRESCOTT, AZ 86304-0880
(928) 759-5987
(928) 458-2039
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5017
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
099588007
MEDICARE WPS
NE
05
—
10025691800
—
NE
01
—
30024
BLUE CROSS BLUE SHIELD OF NEBRASKA
NE
Enumeration date
04/13/2007
Last updated
09/18/2024
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