Healthcare Provider Details

I. General information

NPI: 1497037303
Provider Name (Legal Business Name): MARTIN ZATZ M.D., PH.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2011
Last Update Date: 09/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4853 CORDELL AVE #1009
BETHESDA MD
20814-7055
US

IV. Provider business mailing address

4853 CORDELL AVE #1009
BETHESDA MD
20814
US

V. Phone/Fax

Practice location:
  • Phone: 301-656-4655
  • Fax:
Mailing address:
  • Phone: 301-656-3894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744R1102X
TaxonomyResearch Study Specialist
License NumberD0017344
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: