Individual
MARDI GOMBERG-MAITLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2150 PENNSYLVANIA AVE NW, WASHINGTON, DC 20037-3201
(202) 795-2792
(202) 741-2299
Mailing address
2150 PENNSYLVANIA AVE NW, WASHINGTON, DC 20037-3201
(202) 795-2792
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036109604
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
028257591
—
DC
05
—
119261200
—
MD
05
—
1548323066
—
VA
Enumeration date
12/18/2006
Last updated
10/26/2021
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