Provider Demographics
NPI:1760557011
Name:MARTIN-JONES, MICHELE (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:
Last Name:MARTIN-JONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:MARTIN
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:301 ST. PAUL PL
Mailing Address - Street 2:STE 420
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202
Mailing Address - Country:US
Mailing Address - Phone:410-332-4726
Mailing Address - Fax:410-783-8793
Practice Address - Street 1:301 ST. PAUL PL
Practice Address - Street 2:STE 420
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202
Practice Address - Country:US
Practice Address - Phone:410-332-4726
Practice Address - Fax:410-783-8793
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD41665207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD231111900Medicaid
MD231111900Medicaid
F21921Medicare UPIN