Individual
AMY ELIZABETH MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2181 E COCONINO DR, GILBERT, AZ 85298-6132
(480) 262-8663
(480) 264-6049
Mailing address
2181 E COCONINO DR, GILBERT, AZ 85298-6132
(480) 262-8663
(480) 264-6049
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
11426
MT
208600000X
Surgery Physician
Primary
44731
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000097536
BLUE CROSS BLUE SHIELD MT
MT
01
—
1982650768
MBCHP
MT
05
—
1982650768
—
MT
01
—
611532402
DEPARTMENT OF LABOR
MT
05
—
625707
—
AZ
Enumeration date
05/25/2006
Last updated
08/14/2013
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