Provider Demographics
NPI:1598223091
Name:TRAN, MARTIN
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2405 NORMANDY SQUARE PL APT B
Mailing Address - Street 2:
Mailing Address - City:ASPEN HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20906-6132
Mailing Address - Country:US
Mailing Address - Phone:240-707-5211
Mailing Address - Fax:
Practice Address - Street 1:2405 NORMANDY SQUARE PL APT B
Practice Address - Street 2:
Practice Address - City:ASPEN HILL
Practice Address - State:MD
Practice Address - Zip Code:20906-6132
Practice Address - Country:US
Practice Address - Phone:240-707-5211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
E1976963OtherEMT