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NPI Code Detail

MEDICARE: DR. STEPHANIE D MARTINEZ HAWTHORNE M.D.

MEDICARE:  DR. STEPHANIE D MARTINEZ HAWTHORNE  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0100XGastroenterology Physician29691AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003872037
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHANIE D MARTINEZ HAWTHORNE M.D.
Provider Business Mailing Address
First Line : 7701 W ASPERA BLVD
Second Line :
City : GLENDALE
State : AZ
Zip : 85308-7947
Country : US
Telephone Number : 623-248-2109
Fax Number : 623-707-4893
Provider Business Practice Location Address
First Line : 7701 W ASPERA BLVD
Second Line :
City : GLENDALE
State : AZ
Zip : 85308-7947
Country : US
Telephone Number : 623-248-2109
Fax Number : 623-707-4893
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2006
Last Update Date : 06/25/2022

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