Individual
MARTA MUNDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
11915 GEORGIA AVE, WHEATON, MD 20902-2065
(855) 910-3278
Mailing address
11915 GEORGIA AVE, WHEATON, MD 20902-2065
(240) 354-1307
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110010586
VA
363A00000X
Physician Assistant
C0009674
MD
363A00000X
Physician Assistant
Primary
MA063362
PA
363A00000X
Physician Assistant
OA006015
PA
Other
Enumeration date
04/06/2022
Last updated
12/25/2024
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