Provider Demographics
NPI:1457448631
Name:COLE, MARTHA TOMA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:TOMA
Last Name:COLE
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 1:4701 WILLARD AVE STE 215
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20815-4607
Mailing Address - Country:US
Mailing Address - Phone:301-656-3456
Mailing Address - Fax:301-656-4785
Practice Address - Street 1:4701 WILLARD AVE STE 215
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4607
Practice Address - Country:US
Practice Address - Phone:301-656-3456
Practice Address - Fax:301-656-4785
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD12419174400000X
MDD0025129174400000X
MDD25129207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDC62747Medicare UPIN