# PHYSICAL MEDICINE/REHAB

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255636858
- **Authorized official:** DR. NICHOLETTE MARTIN-DAVIS (MD)
- **Authorized official phone:** (301) 860-0305

## Contact information

- **Practice address:** 4000 MITCHELLVILLE RD, SUITE 324 B, BOWIE, MD 20716-3104
- **Practice address phone:** (301) 860-0306
- **Practice address fax:** (301) 860-0307
- **Mailing address:** 4000 MITCHELLVILLE RD, SUITE 324 B, BOWIE, MD 20716-3104
- **Mailing address phone:** (301) 860-0306
- **Mailing address fax:** (301) 860-0307

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | D0050415 | MD | Yes |

## Other

- **Enumeration date:** 01/13/2011
- **Last updated:** 01/13/2011