Glass, M Martia
Glass, M Martia is an individual health care provider with primary practice located at Us Hwy 491 N , Shiprock NM 87420. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Glass, M Martia can be contacted via phone (505) 368-6401.Contact Information
Primary practice address
Us Hwy 491 N
Shiprock NM 87420
Phone: (505) 368-6401
Fax: (505) 368-6431
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 81204 | New Mexico |
Profile Details
| NPI number | 1295712875 |
|---|---|
| LBN Legal business name | Glass, M Martia |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 27th, 2005 |
| Last updated | Dec 26th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295712875 | NPPES |
| New Mexico | MEDICAID | Q9721 | |
| New Mexico | MEDICAID | 62300733 | |
| New Mexico | MEDICAID | 689870 |
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