Individual
DEBORAH L MARTIN-STOLDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
211 N EDDY ST, SOUTH BEND, IN 46617-2808
(574) 237-9261
(574) 237-9208
Mailing address
211 N EDDY ST, SOUTH BEND, IN 46617-2808
(574) 237-9261
(574) 237-9208
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
71001498A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000526715
ANTHEM BCBS
IN
01
—
000000559594
BCBS
IN
05
—
200423900
—
IN
Enumeration date
10/26/2005
Last updated
08/02/2016
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