Individual
BROOKE G MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5150 JOURNAL CENTER BLVD NE, ALBUQUERQUE, NM 87109-5900
(505) 262-3233
(505) 262-3191
Mailing address
PO BOX 26028, ALBUQUERQUE, NM 87125-6028
(505) 262-7963
(505) 232-1627
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
78-PA005
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
59758
—
NM
Enumeration date
07/11/2006
Last updated
01/31/2019
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