Provider Demographics
NPI:1710982913
Name:MARTIN, AMEETA B (MD)
Entity Type:Individual
Prefix:
First Name:AMEETA
Middle Name:B
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMEETA
Other - Middle Name:B
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2000 Q ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68503-3610
Mailing Address - Country:US
Mailing Address - Phone:402-421-0904
Mailing Address - Fax:402-421-0946
Practice Address - Street 1:575 S 70TH ST STE 425
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2471
Practice Address - Country:US
Practice Address - Phone:402-219-5200
Practice Address - Fax:402-219-5201
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE189472080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
761OtherMIDLAND'S CHOICE
KS100168450CMedicaid
25-02098OtherUHC
00181OtherBCBS
NE47064448313Medicaid
00181OtherBCBS
NE47064448313Medicaid
761OtherMIDLAND'S CHOICE