Provider Demographics
NPI:1568634590
Name:MARTIN, MARIA A (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:A
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2415 MUSGROVE RD STE 302
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-5202
Mailing Address - Country:US
Mailing Address - Phone:301-337-2295
Mailing Address - Fax:301-804-1752
Practice Address - Street 1:2415 MUSGROVE RD STE 302
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-5202
Practice Address - Country:US
Practice Address - Phone:301-337-2295
Practice Address - Fax:301-804-1752
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-31
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0069798207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCMD044445OtherDC LICENSE