Provider Demographics
NPI:1457481194
Name:MARTINEZ GEIGEL, GABRIEL A (MD)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:A
Last Name:MARTINEZ GEIGEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9106 PHILADELPHIA ROAD
Mailing Address - Street 2:SUITE 306
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237
Mailing Address - Country:US
Mailing Address - Phone:410-687-2656
Mailing Address - Fax:410-687-3805
Practice Address - Street 1:9106 PHILADELPHIA ROAD
Practice Address - Street 2:SUITE 306
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237
Practice Address - Country:US
Practice Address - Phone:410-687-2656
Practice Address - Fax:410-687-3805
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2017-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD308092081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
225911OtherMAMSI
4369602OtherAETNA
MD378921700Medicaid
MD5744Medicare ID - Type Unspecified
4369602OtherAETNA