Provider Demographics
NPI:1265504666
Name:MARTINEZ, WENDY (MD)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:
Last Name:MARTINEZ
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 1:2301 EVESHAM RD
Mailing Address - Street 2:BLDG 800, STE 122
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-0598
Mailing Address - Country:US
Mailing Address - Phone:856-770-9300
Mailing Address - Fax:856-770-8238
Practice Address - Street 1:2301 EVESHAM ROAD
Practice Address - Street 2:BLD 800 STE 122
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043
Practice Address - Country:US
Practice Address - Phone:856-770-9300
Practice Address - Fax:856-770-9518
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04947300207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ415759Medicare ID - Type Unspecified
E37328Medicare UPIN