Provider Demographics
NPI:1366820847
Name:MARTINS, MIMI POKUA (MD)
Entity Type:Individual
Prefix:DR
First Name:MIMI
Middle Name:POKUA
Last Name:MARTINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3001 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:CHEVERLY
Mailing Address - State:MD
Mailing Address - Zip Code:20785
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3300 OLNEY SANDY SPRING RD STE 140
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1494
Practice Address - Country:US
Practice Address - Phone:301-570-6245
Practice Address - Fax:240-389-1888
Is Sole Proprietor?:No
Enumeration Date:2015-05-15
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0088689207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine