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Physician Compare National (NPI:1720029887)

HEALTHCARE PROVIDER: GLORIA L MARTIN MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1720029887
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 3072572304
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20041004000527
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name MARTIN
Individual professional last name
Provider First Name GLORIA
Individual professional first name
Provider Middle Name LAVONNE
Individual professional middle name
Provider Gender F
The provider's gender if the provider is a person.
Provider Credential Text MD
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information

Medical School Name UNIVERSITY OF CALIFORNIA, GEFFEN SCHOOL OF MEDICINE
Individual professional's medical school
Graduation Year 1988
Individual professional's medical school graduation year
Primary Specialty OBSTETRICS/GYNECOLOGY
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name ANNETTE F MAYES MD A PROFESSIONAL CORPORATION
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 8628386869
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 4
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 700 SHADOW LN
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 165
Group Practice or individual's line 2 address
City LAS VEGAS
Group Practice or individual's city
State NV
Group Practice or individual's state
Zip Code 891064158
Group Practice or individual's zip code (9 digits when available)
Phone Number 7025229640
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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