Healthcare Provider Details

I. General information

NPI: 1508811928
Provider Name (Legal Business Name): DAVID V. MARTINI, M.D. P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 12/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 E PULASKI HWY
ELKTON MD
21921-6435
US

IV. Provider business mailing address

PO BOX 8571
LANCASTER PA
17604-8571
US

V. Phone/Fax

Practice location:
  • Phone: 410-398-3445
  • Fax: 410-620-1538
Mailing address:
  • Phone: 410-398-3445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID V. MARTINI
Title or Position: AUTHORIZED OFFICIAL
Credential: M.D.
Phone: 410-398-3445