Healthcare Provider Details

I. General information

NPI: 1679710131
Provider Name (Legal Business Name): BARBARA MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2009
Last Update Date: 03/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WISCONSIN AVE AMERICA BUILDING, 4TH DECK ALLERGY & IMMUNOLOGY
BETHESDA MD
20889-0001
US

IV. Provider business mailing address

8901 WISCONSIN AVE AMERICA BUILDING, 4TH DECK ALLERGY & IMMUNOLOGY
BETHESDA MD
20889-0001
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-4510
  • Fax:
Mailing address:
  • Phone: 301-295-4510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberM3012
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD67580
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License NumberM3012
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License NumberD67580
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberM3012
License Number StateTX
# 6
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberD67580
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: