Provider Demographics
NPI:1265451710
Name:MARTIN, CYNTHIA L (MD)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:L
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 E. HAMPDEN AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113
Mailing Address - Country:US
Mailing Address - Phone:303-781-5299
Mailing Address - Fax:303-781-5809
Practice Address - Street 1:701 E HAMPDEN AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113
Practice Address - Country:US
Practice Address - Phone:303-781-5299
Practice Address - Fax:303-781-5809
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO28839207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01288398Medicaid
CO01288398Medicaid
804538Medicare ID - Type Unspecified
C804538Medicare PIN