Individual
BENJAMIN G. MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14300 E 138TH STE A, FISHERS, IN 46037-0087
(317) 813-1660
(317) 813-1667
Mailing address
679 E COUNTY LINE RD, GREENWOOD, IN 46143-1049
(317) 807-1262
(317) 859-4268
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
01069294A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000718633
ANTHEM PIN
IN
01
—
1487680518
GROUP NPI
—
05
—
201029090
—
IN
Enumeration date
05/10/2007
Last updated
01/19/2024
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