Individual
DR. MICHAEL D MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7602 BELAIR RD, BALTIMORE, MD 21236-4088
(410) 663-8100
(410) 659-1549
Mailing address
PO BOX 62026, BALTIMORE, MD 21264-2026
(410) 659-1553
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0041968
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
186591900
—
MD
01
—
KF68/ 525391-08
BC/BS
MH
Enumeration date
04/27/2006
Last updated
12/15/2009
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