Provider Demographics
NPI:1407200470
Name:MALI, MARTINA (MD)
Entity type:Individual
Prefix:
First Name:MARTINA
Middle Name:
Last Name:MALI
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 1:5448 FRANCISCO ROQUE DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79934-3369
Mailing Address - Country:US
Mailing Address - Phone:720-272-9068
Mailing Address - Fax:915-296-5219
Practice Address - Street 1:4669 COHEN AVENUE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79924-4415
Practice Address - Country:US
Practice Address - Phone:915-231-2360
Practice Address - Fax:915-296-5219
Is Sole Proprietor?:No
Enumeration Date:2016-04-15
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS0327207P00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine