Provider Demographics
NPI:1801223102
Name:MARTINEZ, CHARLES ULICK (CRNP)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:ULICK
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5255 LOUGHBORO RD NW
Mailing Address - Street 2:HOSPITALIST SERVICES, 4 WEST
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-2633
Mailing Address - Country:US
Mailing Address - Phone:202-537-4000
Mailing Address - Fax:202-537-4734
Practice Address - Street 1:5255 LOUGHBORO RD NW
Practice Address - Street 2:HOSPITALIST SERVICES
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-2633
Practice Address - Country:US
Practice Address - Phone:202-537-4000
Practice Address - Fax:202-537-4734
Is Sole Proprietor?:No
Enumeration Date:2013-10-01
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1017159363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily