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Individual

LOURDES ECHENIQUE MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2790 GODWIN BLVD STE 360, SUFFOLK, VA 23434-8153
(757) 934-4821
Mailing address
2790 GODWIN BLVD STE 360, SUFFOLK, VA 23434-8153
(757) 934-4821

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101051494
VA
208M00000X
Hospitalist Physician
0101051494
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
200456
ANTHEM BC BS NUMBER
VA
Enumeration date
03/30/2007
Last updated
01/16/2024
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