Provider Demographics
NPI:1851690390
Name:GAUDINSKI, MARTIN ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:ROBERT
Last Name:GAUDINSKI
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 1:10 CENTER DR.
Mailing Address - Street 2:BUILDING 10, ROOM 5-2448
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814
Mailing Address - Country:US
Mailing Address - Phone:301-761-7094
Mailing Address - Fax:
Practice Address - Street 1:10 CENTER DR.
Practice Address - Street 2:BUILDING 10, ROOM 5-2448
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-2081
Practice Address - Country:US
Practice Address - Phone:301-761-7094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-23
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0075190207R00000X
DCMD040882207RA0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine