Healthcare Provider Details

I. General information

NPI: 1780687178
Provider Name (Legal Business Name): MARTIN A. ALBORNOZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MARTIN A ALBORNOZ-SANTOFIMIO M.D.

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3407 WILKENS AVE SUITE 300
BALTIMORE MD
21229-5072
US

IV. Provider business mailing address

3407 WILKENS AVE STE 300
BALTIMORE MD
21229-5222
US

V. Phone/Fax

Practice location:
  • Phone: 410-644-5111
  • Fax: 410-644-2715
Mailing address:
  • Phone: 410-644-5111
  • Fax: 410-644-2715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberD0036373
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberD0036373
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number0434795
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberMD440838
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: