Dianne Martin Md Professional Corporation | |
5670 Caito Dr Suite # 125 Building #5 Indpls IN 46226-1364 | |
(317) 541-9159 | |
(317) 541-9179 |
Full Name | Dianne Martin Md Professional Corporation |
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Speciality | Psychiatry & Neurology |
Location | 5670 Caito Dr, Indpls, Indiana |
Authorized Official Name and Position | Dianne Martin (MD/PSYCHIATRIST) |
Authorized Official Contact | 3175419154 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Dianne Martin Md Professional Corporation 5670 Caito Dr Suite # 125 Building #5 Indpls IN 46226-1364 Ph: (317) 541-9159 | Dianne Martin Md Professional Corporation 5670 Caito Dr Suite # 125 Building #5 Indpls IN 46226-1364 Ph: (317) 541-9159 |
NPI Number | 1891933032 |
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Provider Enumeration Date | 01/27/2009 |
Last Update Date | 05/13/2014 |
Medicare PECOS PAC ID | 7517024664 |
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Medicare Enrollment ID | O20090318000019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891933032 | NPI | - | NPPES |
200930000A | Medicaid | IN | |
100235680 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | 01029502A (Indiana) | Primary |
Provider Name | Dianne Martin |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1215030366 PECOS PAC ID: 8921088691 Enrollment ID: I20040722001102 |
Life Services Eap Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 303 N. Alabama St, Suite 320, Indpls, IN 46204 Phone: 800-822-4847 Fax: 317-262-4633 |