Provider Demographics
NPI:1750688735
Name:MARTINEZ MORALES, ANDY J (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDY
Middle Name:J
Last Name:MARTINEZ MORALES
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 1:7580 BUCKINGHAM BLVD
Mailing Address - Street 2:STE 110
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-3208
Mailing Address - Country:US
Mailing Address - Phone:410-760-4000
Mailing Address - Fax:
Practice Address - Street 1:8901 WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-5285
Practice Address - Country:US
Practice Address - Phone:309-295-4270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-28
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA82208208800000X
VA0101272890208800000X
MDD93287208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrology