Provider Demographics
NPI:1235297201
Name:MARTINEZ, ANA MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:MARIA
Last Name:MARTINEZ
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 1:7942 ROXBURY DR
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-6247
Mailing Address - Country:US
Mailing Address - Phone:410-768-9220
Mailing Address - Fax:
Practice Address - Street 1:7942 ROXBURY DR
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-6247
Practice Address - Country:US
Practice Address - Phone:410-768-9220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0037229207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD296251900Medicaid
MD296251900Medicaid
MD5767AMMedicare ID - Type Unspecified