Provider Demographics
NPI:1760815518
Name:MARTINEZ, ROGELIO II (MD)
Entity Type:Individual
Prefix:DR
First Name:ROGELIO
Middle Name:
Last Name:MARTINEZ
Suffix:II
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 1:8901 WISCONSIN AVE PSYCHIATRY BUILDING 19 RM 6407
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20889-0004
Mailing Address - Country:US
Mailing Address - Phone:301-295-4503
Mailing Address - Fax:301-319-8128
Practice Address - Street 1:5912 TENNESSEE AVE, HHB 101
Practice Address - Street 2:
Practice Address - City:FORT CAMPBELL
Practice Address - State:TN
Practice Address - Zip Code:42223
Practice Address - Country:US
Practice Address - Phone:270-798-4269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-15
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE286662084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry