Provider Demographics
NPI:1700867694
Name:ARROYO, MARTHA P (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:P
Last Name:ARROYO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:920-663-9008
Mailing Address - Fax:920-684-1439
Practice Address - Street 1:1240 N MILWAUKEE AVE STE A
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-1307
Practice Address - Country:US
Practice Address - Phone:847-367-5575
Practice Address - Fax:847-367-5579
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-114928207N00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI48685OtherMEDICAL LICENSE NUMBER
IL036-114928OtherIL MEDICAL LICENSE
H96675Medicare UPIN