Healthcare Provider Details

I. General information

NPI: 1750362505
Provider Name (Legal Business Name): CHRISTOPHER ROBERT MARTIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 ROCKVILLE PICKE WRNMMC
BETHESDA MD
20889-0001
US

IV. Provider business mailing address

8901 ROCKVILLE PIKE WALTER REED NMMC
BETHESDA MD
20889-0001
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-4511
  • Fax:
Mailing address:
  • Phone: 301-295-4511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberMA153515
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number153515
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: