Provider Demographics
NPI:1124349675
Name:MARTINEZ, ANIBAL RAUL (MD)
Entity type:Individual
Prefix:DR
First Name:ANIBAL
Middle Name:RAUL
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1080 S SABLE BLVD UNIT 17-18
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-3796
Mailing Address - Country:US
Mailing Address - Phone:303-552-9577
Mailing Address - Fax:844-621-8050
Practice Address - Street 1:1080 S SABLE BLVD UNIT 17-18
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012
Practice Address - Country:US
Practice Address - Phone:303-552-9577
Practice Address - Fax:844-621-8050
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC164464207Q00000X
CODR.0052857207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine