Individual
DR. ANITA RUTH MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2560 N. SHADELAND AVE., SUITE A, INDIANAPOLIS, IN 46219-1706
(317) 275-8072
(317) 275-8018
Mailing address
14275 MIDWAY RD, SUITE 400, ADDISON, TX 75001-3614
(214) 932-8029
(610) 271-4245
Taxonomy
Speciality
Code
Description
License number
State
207ZH0000X
Hematology (Pathology) Physician
01037421A
IN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
01037421A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000010365
MPLAN
IN
01
—
000000181005
ANTHEM
IN
05
—
200313330A
—
IN
Enumeration date
12/28/2005
Last updated
04/24/2015
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