Healthcare Provider Details

I. General information

NPI: 1457481194
Provider Name (Legal Business Name): GABRIEL A MARTINEZ GEIGEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 06/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9106 PHILADELPHIA ROAD SUITE 306
BALTIMORE MD
21237
US

IV. Provider business mailing address

9106 PHILADELPHIA ROAD SUITE 306
BALTIMORE MD
21237
US

V. Phone/Fax

Practice location:
  • Phone: 410-687-2656
  • Fax: 410-687-3805
Mailing address:
  • Phone: 410-687-2656
  • Fax: 410-687-3805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberD30809
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: