Provider Demographics
NPI:1023109501
Name:DUMMER, MARTHA KAY (MD)
Entity type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:KAY
Last Name:DUMMER
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 1:1426 MIRACERROS LOOP S
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4024
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2213 BROTHERS RD
Practice Address - Street 2:SUITE 600
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-6993
Practice Address - Country:US
Practice Address - Phone:505-986-8645
Practice Address - Fax:505-986-8662
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM98-250NM207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine