Organization
THE PLASTIC & RECONSTRUCTIVE SURGERY INSTITUTE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID ZACHARY MARTIN MD (OWNER/PHYSICIAN)
(443) 687-9990
Entity
Organization
Contact information
Practice address
5601 LOCH RAVEN BLVD, SMYTH PROFESSIONAL BLDG., SUITE 200, BALTIMORE, MD 21239-2905
(443) 687-9990
(443) 740-9278
Mailing address
5601 LOCH RAVEN BLVD, SMYTH PROFESSIONAL BLDG., SUITE 200, BALTIMORE, MD 21239-2905
(443) 687-9990
(443) 740-9278
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
D0058474
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107100
JOHN HOPKINS - EHP, PRIORITY PARTNERS, US FAMILY
MD
01
—
1188979
CIGNA
MD
01
—
1760748800
AMERIGROUP
MD
01
—
1972585206
BRAVO
MD
01
—
AB87
CAREFIRST BLUECROSS BLUESHIELD ALL PRODUCTS
MD
01
—
DS9899
RAILROAD MEDICARE
MD
Enumeration date
04/03/2012
Last updated
09/26/2014
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