Provider Demographics
NPI:1316971047
Name:MARTINEZ, ANTONIO E (MD)
Entity type:Individual
Prefix:
First Name:ANTONIO
Middle Name:E
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 424
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50302-0424
Mailing Address - Country:US
Mailing Address - Phone:515-872-9925
Mailing Address - Fax:515-875-9923
Practice Address - Street 1:5950 UNIVERSITY AVE STE 161
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8234
Practice Address - Country:US
Practice Address - Phone:515-875-9709
Practice Address - Fax:515-875-9702
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95407207ZF0201X, 207ZH0000X, 207ZM0300X, 207ZN0500X, 207ZI0100X, 207ZC0500X, 207ZB0001X, 207ZD0900X
IAMD-46916207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
No207ZM0300XAllopathic & Osteopathic PhysiciansPathologyMedical Microbiology
No207ZN0500XAllopathic & Osteopathic PhysiciansPathologyNeuropathology
No207ZI0100XAllopathic & Osteopathic PhysiciansPathologyImmunopathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
No207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology