Provider Demographics
NPI:1538317243
Name:MARTIN W. GRAF M.D.,P.A.
Entity Type:Organization
Organization Name:MARTIN W. GRAF M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:GRAF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-948-5092
Mailing Address - Street 1:15225 SHADY GROVE RD
Mailing Address - Street 2:203
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3254
Mailing Address - Country:US
Mailing Address - Phone:301-948-5092
Mailing Address - Fax:301-977-7811
Practice Address - Street 1:15225 SHADY GROVE RD
Practice Address - Street 2:SUITE 203
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3254
Practice Address - Country:US
Practice Address - Phone:301-948-5092
Practice Address - Fax:301-977-7811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-05
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07162261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDC62159Medicare UPIN