| 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 |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 01/27/2009 |
| Last Update Date | 05/13/2014 |
| Medicare PECOS PAC ID | 7517024664 |
|---|---|
| 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 |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215030366 PECOS PAC ID: 8921088691 Enrollment ID: I20040722001102 |
Workplace Services Corp 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 |