Individual
RICHARD MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
9420 KEY WEST AVE STE 420, ROCKVILLE, MD 20850-6509
(301) 258-1919
(301) 258-9180
Mailing address
105 SHORT ST, GAITHERSBURG, MD 20878-3221
(202) 236-1072
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C0004286
MD
Other
Enumeration date
10/07/2010
Last updated
10/02/2021
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