Basic Information
| Provider Information | |||||||||
| NPI: | 1679768659 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AMAT-MARTINEZ | ||||||||
| FirstName: | BELEN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 MICHIGAN ST NE # MC845 | ||||||||
| Address2: | |||||||||
| City: | GRAND RAPIDS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 495032560 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6164866790 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1005 W GREEN ST STE G100 | ||||||||
| Address2: | |||||||||
| City: | HASTINGS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 490581727 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2699450922 | ||||||||
| FaxNumber: | 2699454511 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2007 | ||||||||
| LastUpdateDate: | 01/04/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 4301090707 | MI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RA0000X | 4301090707 | MI | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Adolescent Medicine | 208000000X | 4301090707 | MI | N | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.