Individual
DR. DERRICK A MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
7501 GREENWAY CENTER DR, SUITE 800, GREENBELT, MD 20770-3514
(301) 220-2316
(301) 220-2319
Mailing address
7501 GREENWAY CENTER DR, SUITE 800, GREENBELT, MD 20770-3514
(301) 220-2316
(301) 220-2319
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
18131
MD
225100000X
Physical Therapist
2656
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001
CAREFIRST BCBS
DC
01
—
01302934
AMERIGROUP
MD
01
—
545048096
CAREFIRST BCBS
MD
05
—
961002200
—
MD
Enumeration date
03/22/2007
Last updated
11/27/2009
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