Provider Demographics
NPI:1528361003
Name:MARTIN C. FLAUM DPM PC
Entity Type:Organization
Organization Name:MARTIN C. FLAUM DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTHWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:604-599-1895
Mailing Address - Street 1:50 W EDMONSTON DR
Mailing Address - Street 2:SUITE 306
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-1280
Mailing Address - Country:US
Mailing Address - Phone:301-340-8666
Mailing Address - Fax:301-340-7448
Practice Address - Street 1:50 W EDMONSTON DR
Practice Address - Street 2:SUITE 306
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1280
Practice Address - Country:US
Practice Address - Phone:301-340-8666
Practice Address - Fax:301-340-7448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-06
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00303213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD400136Medicare PIN