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General NPI Number Information
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NPI Number | 1588996870
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Entity Type | Organization
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Legal Business Name | MARTIN CENTER, INC.
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Dates
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Enumeration Date | 02/11/2010
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Last Update Date | 02/11/2010
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Provider Practice Location Address
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Address Line | 3549 N COLLEGE AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46205-3733
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Country | US
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Telephone | 317-927-5158
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Fax | 317-927-5168
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Provider Business Mailing Address
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Address Line | 3549 NORTH COLLEGE AVENUE 3545 NORTH COLLEGE AVNEUE
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City | INDIANAPOLIS
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State | NONE
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Zip | 46205
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Country | UM
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Telephone | 317-927-5158
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Fax | 317-927-5168
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Authorized Official
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Title or Position | MEDICAL
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Name | DR. RAYMOND PIERCE
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Credential | M.D.
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Telephone | 317-414-2215
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 15D0881423
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License Number State | IN
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