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General NPI Number Information
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NPI Number | 1407895451
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Entity Type | Organization
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Legal Business Name | GLORIA L MARTIN MD LTD
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2010 GOLDRING AVE #303
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City | LAS VEGAS
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State | NV
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Zip | 89106
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Country | US
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Telephone | 702-385-3070
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Fax | 702-650-0548
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Provider Business Mailing Address
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Address Line | 1000 N GREEN VALLEY PKWY #440-164
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City | HENDERON
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State | NV
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Zip | 89074
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Country | US
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Telephone | 702-385-3070
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Fax | 702-650-0548
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Authorized Official
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Title or Position | OWNER
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Name | GLORIA L MARTIN
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Credential | MD
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Telephone | 702-385-3070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 6945
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License Number State | NV
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