Provider Demographics
NPI:1518708130
Name:ML PRIMARY CARE PLLC
Entity type:Organization
Organization Name:ML PRIMARY CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DNP
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:832-867-0760
Mailing Address - Street 1:207 CENTRAL DR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-5107
Mailing Address - Country:US
Mailing Address - Phone:832-867-0760
Mailing Address - Fax:
Practice Address - Street 1:1425 S MOORE RD STE C
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37412-2836
Practice Address - Country:US
Practice Address - Phone:423-287-6805
Practice Address - Fax:423-287-6806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty