Provider Demographics
NPI:1295995587
Name:DONOGHUE, MARTHA BOERI (MD)
Entity type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:BOERI
Last Name:DONOGHUE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 ELLICOTT ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-2026
Mailing Address - Country:US
Mailing Address - Phone:202-487-9658
Mailing Address - Fax:
Practice Address - Street 1:3101 ELLICOTT ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-2026
Practice Address - Country:US
Practice Address - Phone:202-487-9658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD311462080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology