Provider Demographics
NPI:1699709733
Name:MARTINEZ, ANDREW D (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:D
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2862 S CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-4101
Mailing Address - Country:US
Mailing Address - Phone:719-226-4511
Mailing Address - Fax:719-226-4565
Practice Address - Street 1:2862 S CIRCLE DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-4101
Practice Address - Country:US
Practice Address - Phone:719-226-4511
Practice Address - Fax:719-226-4565
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO35824207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM53636562Medicaid
NM53636562Medicaid
D01711Medicare UPIN